Provider Demographics
NPI:1215293345
Name:FLORES, AMI M (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:AMI
Middle Name:M
Last Name:FLORES
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 PEACH CT UNIT 3
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-8311
Mailing Address - Country:US
Mailing Address - Phone:707-761-2376
Mailing Address - Fax:
Practice Address - Street 1:1823 PEACH CT UNIT 3
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91913-8311
Practice Address - Country:US
Practice Address - Phone:707-761-2376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA731358163WE0003X, 364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No163WE0003XNursing Service ProvidersRegistered NurseEmergency