Provider Demographics
NPI:1366275711
Name:FLORES, ALVIN PANGILINAN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MR
First Name:ALVIN
Middle Name:PANGILINAN
Last Name:FLORES
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 RANGE RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-1927
Mailing Address - Country:US
Mailing Address - Phone:702-668-4785
Mailing Address - Fax:
Practice Address - Street 1:1825 CIVIC CENTER DR
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7113
Practice Address - Country:US
Practice Address - Phone:702-642-8313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV878533363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily