Provider Demographics
NPI:1346295565
Name:FLORES, ANA L (MD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:L
Last Name:FLORES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6029 WALNUT GROVE ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120
Mailing Address - Country:US
Mailing Address - Phone:901-747-3900
Mailing Address - Fax:901-791-4215
Practice Address - Street 1:6029 WALNUT GROVE ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120
Practice Address - Country:US
Practice Address - Phone:901-747-3900
Practice Address - Fax:901-747-0756
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE3059207WX0107X
MS17369207WX0107X
FLME94638207WX0107X
TNTN35402207WX0107X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3865383Medicaid
TN38653811Medicaid
TNH40708Medicare UPIN
TN38653811Medicaid
TN3865383Medicare ID - Type Unspecified