Provider Demographics
NPI:1902000599
Name:ANGELES, CARMINA FLORES (MD)
Entity Type:Individual
Prefix:DR
First Name:CARMINA
Middle Name:FLORES
Last Name:ANGELES
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 1:1410 OAK ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4604
Mailing Address - Country:US
Mailing Address - Phone:877-852-7246
Mailing Address - Fax:
Practice Address - Street 1:74B CENTENNIAL LOOP STE 100
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7919
Practice Address - Country:US
Practice Address - Phone:541-686-3791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD150854207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
681464525OtherMYUTMB 681464525-COMMERCIAL NUMBER