Provider Demographics
NPI:1205543543
Name:FLORES, GABRIEL (PT)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:FLORES
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Gender:M
Credentials:PT
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1650 LYNDON FARM CT STE 300
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5005
Mailing Address - Country:US
Mailing Address - Phone:951-335-9825
Mailing Address - Fax:951-666-5096
Practice Address - Street 1:1630 W REDLANDS BLVD STE L
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-8032
Practice Address - Country:US
Practice Address - Phone:909-335-0059
Practice Address - Fax:909-335-2828
Is Sole Proprietor?:No
Enumeration Date:2022-11-04
Last Update Date:2022-11-18
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant