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NPI Code Detail

MEDICARE: MISS ANTOINETTE GRACE FLORES NP

MEDICARE: MISS ANTOINETTE GRACE FLORES NP
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
1363LP2300XPrimary Care Nurse Practitioner261176AZ
2363LP0808XPsychiatric/Mental Health Nurse Practitioner261176AZ

General Provider Information

NPI Number : 1669140299
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ANTOINETTE GRACE FLORES NP
Provider Business Mailing Address
First Line : 13755 N LITCHFIELD RD STE 105
Second Line :
City : SURPRISE
State : AZ
Zip : 85379-4288
Country : US
Telephone Number : 623-322-5900
Fax Number : 623-249-4344
Provider Business Practice Location Address
First Line : 1860 N 95TH LN STE 300
Second Line :
City : PHOENIX
State : AZ
Zip : 85037-5074
Country : US
Telephone Number : 806-267-5844
Fax Number : 480-210-0230
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2021
Last Update Date : 01/24/2024

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