Provider Demographics
NPI:1629282397
Name:FLORES, ELIDA (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MS
First Name:ELIDA
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3441 SUNFLOWER CT
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-8424
Mailing Address - Country:US
Mailing Address - Phone:619-962-1089
Mailing Address - Fax:
Practice Address - Street 1:3441 SUNFLOWER CT
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-8424
Practice Address - Country:US
Practice Address - Phone:619-962-1089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21941183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician