Provider Demographics
NPI:1780887471
Name:FLORA FLORES PACIS MD
Entity type:Organization
Organization Name:FLORA FLORES PACIS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FLORA
Authorized Official - Middle Name:FLORES
Authorized Official - Last Name:PACIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-855-4544
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:CHAPMANVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25508
Mailing Address - Country:US
Mailing Address - Phone:304-855-4544
Mailing Address - Fax:
Practice Address - Street 1:6303 C MAIN STREET
Practice Address - Street 2:
Practice Address - City:CHAPMANVILLE
Practice Address - State:WV
Practice Address - Zip Code:25508
Practice Address - Country:US
Practice Address - Phone:304-855-4544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty