Provider Demographics
NPI:1649665894
Name:FLORES, LUIS ORLANDO (LICENSED OPTICIAN)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:ORLANDO
Last Name:FLORES
Suffix:
Gender:M
Credentials:LICENSED OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 N EASTERN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-3453
Mailing Address - Country:US
Mailing Address - Phone:914-449-1831
Mailing Address - Fax:
Practice Address - Street 1:556 N EASTERN AVE STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-3453
Practice Address - Country:US
Practice Address - Phone:702-385-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-04
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDR4154156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician