Provider Demographics
NPI:1093760159
Name:FLORES, IRIS L (OD)
Entity Type:Individual
Prefix:DR
First Name:IRIS
Middle Name:L
Last Name:FLORES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22603-1924
Mailing Address - Country:US
Mailing Address - Phone:540-336-5364
Mailing Address - Fax:
Practice Address - Street 1:675 ADAMS RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22603-1924
Practice Address - Country:US
Practice Address - Phone:540-336-3364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2019-12-26
Deactivation Date:2018-08-16
Deactivation Code:
Reactivation Date:2019-12-18
Provider Licenses
StateLicense IDTaxonomies
VA0618000575152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA231505OtherANTHEM BCBS
T31268Medicare UPIN
VA410000751Medicare ID - Type Unspecified