Provider Demographics
NPI:1003034679
Name:FLORES, RICHARD A (CNIM)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:A
Last Name:FLORES
Suffix:
Gender:M
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21933 E RIDGE TRAIL CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-2665
Mailing Address - Country:US
Mailing Address - Phone:303-426-3927
Mailing Address - Fax:720-876-1315
Practice Address - Street 1:10940 S PARKER RD
Practice Address - Street 2:#130
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7440
Practice Address - Country:US
Practice Address - Phone:303-426-3927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO470246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic