| NPI Details | |
|---|---|
| NPI | 1043239866 |
| Gender | Male |
| Enumeration Date | 07/19/2006 |
| Last Updated | 01/21/2014 |
| Entity Type | Individual |
| Active | Over 11 years ago |
| Practice Location | |
|---|---|
| 1651 SE TIFFANY AVE PORT ST LUCIE FL, 34952-7564, US |
|
| Phone | (772) 398-1800 |
| Fax | (772) 398-1815 |
| Business Location | |
|---|---|
| PO BOX 417 STUART FL, 34995-0417, US |
|
| Phone | (772) 223-5665 |
| Fax | (772) 223-5646 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 207RG0100X |
| License State | Florida |
| License Number | OS6311 |
| Remove 1043239866 NPI Number | |
According to our database, Edwin D. Flanagan D.O. NPI is 1043239866, taxonomy code is 207RG0100X and license number is OS6311, license state is located at Florida. Edwin D. Flanagan D.O. physically located at 1651 Se Tiffany Ave, Port St Lucie FL, 34952-7564. NPI Number Edwin D. Flanagan D.O. has the Individual type.
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1043239866 NPI number is provided on an as is basis without warranty of any kind. 1043239866 is maintained by the National Plan & Provider Enumeration System. The contents of Edwin D. Flanagan D.O. are for informational purposes only.
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