Provider Demographics
NPI:1710537808
Name:FLORES, VERONICA ISABEL
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:ISABEL
Last Name:FLORES
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 1:12049 BRAVEHEART AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-0373
Mailing Address - Country:US
Mailing Address - Phone:915-637-3440
Mailing Address - Fax:
Practice Address - Street 1:12049 BRAVEHEART AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-0373
Practice Address - Country:US
Practice Address - Phone:915-637-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider