Provider Demographics
NPI:1205813219
Name:FLORES, JOSE A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:A
Last Name:FLORES
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:4351 E LOHMAN AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-8259
Mailing Address - Country:US
Mailing Address - Phone:505-532-8900
Mailing Address - Fax:505-532-8974
Practice Address - Street 1:4351 E LOHMAN AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8259
Practice Address - Country:US
Practice Address - Phone:505-532-8900
Practice Address - Fax:505-532-8974
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NM2002-0406207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM83682082Medicaid
NMH71295Medicare UPIN