Organization
GREEN MOUNTAIN HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTO FLORES (ADMINISTRATOR/OWNER)
(915) 276-0865
Entity
Organization
Contact information
Practice address
2311 N MESA ST STE H, EL PASO, TX 79902-3575
(915) 500-4883
(915) 275-5510
Mailing address
2311 N MESA ST STE H, EL PASO, TX 79902-3575
(915) 500-4883
(915) 275-5510
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
07/19/2022
Last updated
07/19/2022
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