MEDICARE: BROOKE LANAE 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	225100000X	Physical Therapist	PTL.0017124	CO

General Provider Information

NPI Number	:	1457964793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE LANAE FLORES

Provider Business Mailing Address
First Line	:	1325 S COLORADO BLVD STE 206
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-3311
Country	:	US
Telephone Number	:	303-394-3356
Fax Number	:

Provider Business Practice Location Address
First Line	:	1325 S COLORADO BLVD STE 206
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-3311
Country	:	US
Telephone Number	:	303-394-3356
Fax Number	:

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

Provider Enumeration Date	:	08/26/2020
Last Update Date	:	08/26/2020

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Directions to “ BROOKE LANAE FLORES ” Practice Location

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