Provider Demographics
NPI:1699767657
Name:FLORES MORALES, REBECA (MD)
Entity type:Individual
Prefix:
First Name:REBECA
Middle Name:
Last Name:FLORES MORALES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438A LAWTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-1911
Mailing Address - Country:US
Mailing Address - Phone:201-214-3620
Mailing Address - Fax:
Practice Address - Street 1:6010 W AMARILLO BLVD
Practice Address - Street 2:AMARILLO VA HEALTH CARE SYSTEM
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1990
Practice Address - Country:US
Practice Address - Phone:940-937-8528
Practice Address - Fax:940-937-8628
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10105207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
4276OtherFIRST MEDICAL
7310131OtherHUMANA INSURANCE
212376OtherPREFERED HEALTH CARE
7310131OtherHUMANA HEALTH PLANS
1533OtherAMERICAN HEALTH
83059FLOtherSSS
PE4249OtherPALIC
200074OtherMEDICARE Y MUCHO MAS
064683OtherLA CRUZ AZUL
83059FLOtherSSS
F36825Medicare UPIN