MEDICARE: SHAMECCA NAKIA FLORES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor

General Provider Information

NPI Number	:	1407457104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAMECCA NAKIA FLORES

Provider Business Mailing Address
First Line	:	848 N RAINBOW BLVD # 172
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-1103
Country	:	US
Telephone Number	:	702-538-1786
Fax Number	:

Provider Business Practice Location Address
First Line	:	4827 DONNA ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-3045
Country	:	US
Telephone Number	:	702-538-1786
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2020
Last Update Date	:	11/08/2020

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Directions to “ SHAMECCA NAKIA FLORES ” Practice Location

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