Provider Demographics
NPI:1891743845
Name:FLORES, LAMBERTO OPULENCIA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAMBERTO
Middle Name:OPULENCIA
Last Name:FLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1215
Mailing Address - Street 2:ATTN CLINIC BILLING OFFICE
Mailing Address - City:LIBERAL
Mailing Address - State:KS
Mailing Address - Zip Code:67905-1215
Mailing Address - Country:US
Mailing Address - Phone:620-629-6638
Mailing Address - Fax:620-629-6684
Practice Address - Street 1:305 W 15TH ST
Practice Address - Street 2:STE 104
Practice Address - City:LIBERAL
Practice Address - State:KS
Practice Address - Zip Code:67901-2455
Practice Address - Country:US
Practice Address - Phone:620-624-9637
Practice Address - Fax:620-624-2218
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-34311207V00000X, 207V00000X
KS0434311207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200644000JMedicaid
OK200313900AMedicaid
KS110607028Medicare PIN