Doctor Name: | RANDY FLORES |
NPI Number: | 1023258969 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | |
Business Practice Address: | 2450 W Charleston Blvd Las Vegas, NV - 891022179 |
Business Phone Number: | 7028778660 |
Business Fax Number: | 7022581322 |
Mailing Address: | Po Box 35380, LAS VEGAS |
State: | NV |
Postal Code: | 891335380 |
Phone Number: | 7028778661 |
Fax Number: | 7022588132 |
NPI Enumeration Date: | 03/05/2009 |
NPI Last Update Date: | 09/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |