Organization Name: | FLAGLER HEALTH SERVICES, INC. |
NPI Number: | 1801164504 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH S GORDY (CEO) |
Mailing Address: | 400 Health Park Blvd Saint Augustine |
State: | FL US |
Postal Code: | 320865784 |
Phone Number: | 9048195155 |
Fax Number: | 9048194906 |
NPI Enumeration Date: | 12/08/2011 |
NPI Last Update Date: | 12/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |