Provider Demographics
NPI:1487963609
Name:TINGZON, FLORA PERILLO (RN)
Entity type:Individual
Prefix:MRS
First Name:FLORA
Middle Name:PERILLO
Last Name:TINGZON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5779 RADIO CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-6572
Mailing Address - Country:US
Mailing Address - Phone:619-264-1982
Mailing Address - Fax:
Practice Address - Street 1:5779 RADIO CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92114-6572
Practice Address - Country:US
Practice Address - Phone:619-264-1982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN521066163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse