Provider Demographics
NPI:1164023339
Name:FIMBRES, FLOR AVILA (NP)
Entity Type:Individual
Prefix:
First Name:FLOR
Middle Name:AVILA
Last Name:FIMBRES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:FLOR
Other - Middle Name:A
Other - Last Name:FIMBRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FLOR AVILA
Mailing Address - Street 1:PO BOX 914
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-1189
Mailing Address - Country:US
Mailing Address - Phone:800-640-3451
Mailing Address - Fax:
Practice Address - Street 1:4921 E BELL RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6002
Practice Address - Country:US
Practice Address - Phone:800-640-3451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ240769363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner