Provider Demographics
NPI:1710025168
Name:FLORES, MICHELLE SOPHIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:SOPHIA
Last Name:FLORES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WILFORD HALL MEDICAL CENTER
Mailing Address - Street 2:1100 WILFORD HALL LOOP
Mailing Address - City:LACKLAND AIR FORCE BASE
Mailing Address - State:TX
Mailing Address - Zip Code:78236-5113
Mailing Address - Country:US
Mailing Address - Phone:210-292-4277
Mailing Address - Fax:
Practice Address - Street 1:1100 WILFORD HALL LOOP
Practice Address - Street 2:
Practice Address - City:JBSA LACKLAND
Practice Address - State:TX
Practice Address - Zip Code:78236-5638
Practice Address - Country:US
Practice Address - Phone:210-292-4277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01050630A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics