Provider Demographics
NPI:1477745768
Name:RUIZ-FLORES, ROSE M (PA)
Entity type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:M
Last Name:RUIZ-FLORES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1530 W 6TH ST STE 109
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-2784
Mailing Address - Country:US
Mailing Address - Phone:951-279-2171
Mailing Address - Fax:951-279-4514
Practice Address - Street 1:1530 W 6TH ST STE 109
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-2784
Practice Address - Country:US
Practice Address - Phone:951-279-2171
Practice Address - Fax:951-279-4514
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17238363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical