FLAGEL PEDIATRIC & FAMILY MEDICINE P A (NPI# 1790090538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790090538 |
Entity Type | Organization |
Organization Name | FLAGEL PEDIATRIC & FAMILY MEDICINE P A |
Practice Address |
2572 Commerce Parkway North Port FL 34289 |
Practice Telephone | 9414293545 |
Practice Fax Number | 9414293546 |
Mailing Telephone | 9414293545 |
Mailing Fax Number | 9414293546 |
Enumeration Date | 2010-08-17 |
Last Update Date | 2017-03-28 |
Authorized Official Name | SUSAN D FLAGEL (OWNER/OPERATOR) |
Authorized Official Telephone | 9414293545 |
Authorized Official Credential | DO |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
OS 10992 | FL | Ambulatory Health Care Facilities |
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
ME 107190 | FL | Ambulatory Health Care Facilities |
Street Address |
2572 COMMERCE PARKWAY |
City | NORTH PORT |
State | FL |
Zip Code | 34289 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477085439 | Heather Proctor | Counselor | 2571 N Toledo Blade Blvd Unit 3, North Port, FL 34289 | 2017-03-29 |
1649538281 | Lisa Beth Gussin | Counselor | 2562 Commerce Parkway, North Port, FL 34289 | 2012-05-02 |
1427101773 | Belinda Alma | Counselor | 2564 Commerce Pkwy., Suite 1, North Port, FL 34289 | 2007-01-19 |
1659477727 | Mark C Burne | Dentist | 2787 Sycamore St, Building F, Suite 106, North Port, FL 34289 | 2006-09-16 |
1710119177 | North Port Oral Surgery Inc. | Clinic/Center | 2787 Sycamore St, Building F, Suite 106, North Port, FL 34289 | 2009-08-19 |
1184885014 | Maytal Adlersberg | Physical Therapy Assistant | 2334 Rosewood Ln, North Port, FL 34289-1404 | 2008-06-23 |
1578698346 | Daniela Sodre | Speech-Language Pathologist | 2565 N Toledo Blade Blvd, North Port, FL 34289-9306 | 2007-02-22 |
1316551765 | Heather Sifford | Behavior Technician | 2565 N Toledo Blade Blvd, North Port, FL 34289-9306 | 2020-09-03 |
1619590460 | Cassie Wills | Behavior Technician | 2565 N Toledo Blade Blvd, North Port, FL 34289-9306 | 2020-05-27 |
1992328819 | Jennifer Charles | Behavior Technician | 2565 N Toledo Blade Blvd, North Port, FL 34289-9306 | 2020-05-27 |
Find all providers in zip 34289 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
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1003216821 | Ludmila Shimanovsky | Clinic/Center | 1157 Jonah Dr, North Port, FL 34289-9496 | 2014-08-28 |
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Find all providers with the same taxonomy |
City | NORTH PORT |
Zip Code | 34289 |
Please comment or provide details below to improve the information on FLAGEL PEDIATRIC & FAMILY MEDICINE P A.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.