Provider Demographics
NPI:1629626858
Name:FLOLO, ALEXANDRA R
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:R
Last Name:FLOLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45042 CORTE BELLA DONNA
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-1055
Mailing Address - Country:US
Mailing Address - Phone:310-592-5853
Mailing Address - Fax:
Practice Address - Street 1:45042 CORTE BELLA DONNA
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-1055
Practice Address - Country:US
Practice Address - Phone:310-592-5853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider