Provider Demographics
NPI:1649881723
Name:FLORES, CECILIA (CSFA)
Entity type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:MS
Other - First Name:CECILIA
Other - Middle Name:
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CSFA
Mailing Address - Street 1:4245 BASSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-6645
Mailing Address - Country:US
Mailing Address - Phone:719-439-8522
Mailing Address - Fax:
Practice Address - Street 1:4245 BASSWOOD DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-6645
Practice Address - Country:US
Practice Address - Phone:719-439-8522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONB00092518246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant