Provider Demographics
NPI:1831980655
Name:FLORES, RUBY
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:
Last Name:FLORES
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3712 FORNOFF AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-6224
Mailing Address - Country:US
Mailing Address - Phone:402-490-0143
Mailing Address - Fax:402-490-0143
Practice Address - Street 1:13939 GOLD CIR LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2310
Practice Address - Country:US
Practice Address - Phone:402-982-9254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion