Provider Demographics
NPI:1144015306
Name:FLORES, PAOLA L (IHS)
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:L
Last Name:FLORES
Suffix:
Gender:F
Credentials:IHS
Other - Prefix:
Other - First Name:PAOLA
Other - Middle Name:LISETH
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:IHS
Mailing Address - Street 1:61133 BROSTERHOUS RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-9735
Mailing Address - Country:US
Mailing Address - Phone:541-279-7197
Mailing Address - Fax:
Practice Address - Street 1:255 SW BLUFF DR UNIT 210
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3220
Practice Address - Country:US
Practice Address - Phone:541-306-5111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10212601237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty