Individual
MRS. LARISSA FLORES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 W CLARENDON AVE STE 200, PHOENIX, AZ 85013-3422
(602) 776-0776
(602) 705-0567
Mailing address
300 W CLARENDON AVE STE 200, PHOENIX, AZ 85013-3422
(602) 776-0776
(602) 705-0567
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP9917
AZ
364SF0001X
Family Health Clinical Nurse Specialist
Primary
AP9917
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
257668
—
AZ
01
—
Z201263
MEDICARE
AZ
Enumeration date
04/09/2017
Last updated
12/27/2024
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