Provider Demographics
NPI:1043715907
Name:FLORES RODARTE, JOSE CARLOS (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:CARLOS
Last Name:FLORES RODARTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:955 POWELL AVE SW
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2908
Mailing Address - Country:US
Mailing Address - Phone:425-277-1311
Mailing Address - Fax:425-277-1566
Practice Address - Street 1:4040 S 188TH ST STE 201
Practice Address - Street 2:
Practice Address - City:SEATAC
Practice Address - State:WA
Practice Address - Zip Code:98188-5070
Practice Address - Country:US
Practice Address - Phone:206-277-7200
Practice Address - Fax:206-277-7202
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2025-01-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD61178793207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine