Provider Demographics
NPI:1306334123
Name:FLORES VAZQUEZ, ZULMA
Entity type:Individual
Prefix:
First Name:ZULMA
Middle Name:
Last Name:FLORES VAZQUEZ
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 1:8290 W SAHARA AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8933
Mailing Address - Country:US
Mailing Address - Phone:702-262-9949
Mailing Address - Fax:
Practice Address - Street 1:3925 N MLK BLVD STE 212
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-7676
Practice Address - Country:US
Practice Address - Phone:702-461-1982
Practice Address - Fax:702-644-6260
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2020-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1417405358Medicaid