Individual
IVAN FLORES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1111 E BRICKYARD RD APT 430, SALT LAKE CITY, UT 84106-3698
(801) 916-4887
Mailing address
1111 E BRICKYARD RD APT 430, SALT LAKE CITY, UT 84106-3698
(801) 916-4887
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14225518-1206
UT
Other
Enumeration date
06/05/2025
Last updated
12/31/2025
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