Healthcare Provider Details

I. General information

NPI: 1487985099
Provider Name (Legal Business Name): FLAPCA ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2010
Last Update Date: 05/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3013 YAMATO RD SUITE B-14
BOCA RATON FL
33434-5356
US

IV. Provider business mailing address

3013 YAMATO RD SUITE B-14
BOCA RATON FL
33434-5356
US

V. Phone/Fax

Practice location:
  • Phone: 561-826-5483
  • Fax: 561-826-1005
Mailing address:
  • Phone: 561-826-5483
  • Fax: 561-826-1005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberN/A
License Number StateCA

VIII. Authorized Official

Name: JODI MCCARTY
Title or Position: PRESIDENT
Credential: M.A.
Phone: 561-826-5483