Provider Demographics
NPI:1881816791
Name:FLORES, DANIEL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:FLORES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3136 BIGHORN CT
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81005-4016
Mailing Address - Country:US
Mailing Address - Phone:719-320-0329
Mailing Address - Fax:719-566-1980
Practice Address - Street 1:3136 BIGHORN CT
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81005-4016
Practice Address - Country:US
Practice Address - Phone:719-320-0329
Practice Address - Fax:719-566-1980
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant