Provider Demographics
NPI:1528886272
Name:FLORES MARTINEZ, STEFANY PATRICIA
Entity type:Individual
Prefix:
First Name:STEFANY
Middle Name:PATRICIA
Last Name:FLORES MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEFANY
Other - Middle Name:P
Other - Last Name:FLORES MARTINEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2850 LINDELL RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-6815
Mailing Address - Country:US
Mailing Address - Phone:702-253-2806
Mailing Address - Fax:
Practice Address - Street 1:2850 LINDELL RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6815
Practice Address - Country:US
Practice Address - Phone:702-253-2806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program