Provider Demographics
NPI:1124203054
Name:FLORES ERAZO, ANTONIO MARTIN (MD)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:MARTIN
Last Name:FLORES ERAZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9280 W SUNSET RD
Mailing Address - Street 2:SUITE 312
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-4860
Mailing Address - Country:US
Mailing Address - Phone:702-737-5864
Mailing Address - Fax:
Practice Address - Street 1:3150 N TENAYA WAY
Practice Address - Street 2:SUITE 125
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0443
Practice Address - Country:US
Practice Address - Phone:702-869-0855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125048883207R00000X
NV13889207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine