Healthcare Provider Details

I. General information

NPI: 1992328199
Provider Name (Legal Business Name): KRISTYN NICOLE FLYNN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2020
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2776 CLEVELAND AVE
FORT MYERS FL
33901-5864
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-2000
  • Fax:
Mailing address:
  • Phone: 239-343-0709
  • Fax: 239-343-0533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License NumberOS19731
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: