MEDICARE: KATHLEEN NOONAN 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	2305005699	VA

General Provider Information

NPI Number	:	1841434412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN NOONAN FLORES

Provider Business Mailing Address
First Line	:	16173 DILIGENCE CT
Second Line	:
City	:	BEAVERDAM
State	:	VA
Zip	:	23015-1570
Country	:	US
Telephone Number	:	804-304-9524
Fax Number	:

Provider Business Practice Location Address
First Line	:	16173 DILIGENCE CT
Second Line	:
City	:	BEAVERDAM
State	:	VA
Zip	:	23015-1570
Country	:	US
Telephone Number	:	804-304-9524
Fax Number	:

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

Provider Enumeration Date	:	04/28/2009
Last Update Date	:	04/28/2009

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