Provider Demographics
NPI:1669661963
Name:FLORES, MARITZA EDITH (MEDICALASSISTANT)
Entity Type:Individual
Prefix:
First Name:MARITZA
Middle Name:EDITH
Last Name:FLORES
Suffix:
Gender:F
Credentials:MEDICALASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:BELL
Mailing Address - State:CA
Mailing Address - Zip Code:90201-3646
Mailing Address - Country:US
Mailing Address - Phone:323-562-6700
Mailing Address - Fax:323-562-9802
Practice Address - Street 1:6901 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BELL
Practice Address - State:CA
Practice Address - Zip Code:90201-3646
Practice Address - Country:US
Practice Address - Phone:323-562-6700
Practice Address - Fax:323-562-9802
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker