Provider Demographics
NPI:1841071883
Name:DFLORES, ELENA
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:DFLORES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1653 HONDELEAU LN
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7223
Mailing Address - Country:US
Mailing Address - Phone:541-944-8818
Mailing Address - Fax:
Practice Address - Street 1:1653 HONDELEAU LN
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-7223
Practice Address - Country:US
Practice Address - Phone:541-944-8818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter