Provider Demographics
NPI:1043466048
Name:FLOREZ, SANDRA I (MOTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:I
Last Name:FLOREZ
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:I
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOTR/L
Mailing Address - Street 1:609 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-4316
Mailing Address - Country:US
Mailing Address - Phone:505-887-3762
Mailing Address - Fax:
Practice Address - Street 1:1905 W PIERCE ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-4025
Practice Address - Country:US
Practice Address - Phone:505-885-3161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1955225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist