Provider Demographics
NPI:1891282620
Name:RIVERA FLORES, ESTEFANIA (MD)
Entity type:Individual
Prefix:
First Name:ESTEFANIA
Middle Name:
Last Name:RIVERA FLORES
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 1:9009 VINO CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-9121
Mailing Address - Country:US
Mailing Address - Phone:857-272-4707
Mailing Address - Fax:
Practice Address - Street 1:2000 CAROMONT PKWY
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-0157
Practice Address - Country:US
Practice Address - Phone:704-834-2890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC324032208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics