Healthcare Provider Details

I. General information

NPI: 1184277576
Provider Name (Legal Business Name): FLYING NURSES INTERNATIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2019
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PALM COAST PKWY NE STE 607-265
PALM COAST FL
32137-8224
US

IV. Provider business mailing address

250 PALM COAST PKWY NE STE 607-265
PALM COAST FL
32137-8224
US

V. Phone/Fax

Practice location:
  • Phone: 877-521-1333
  • Fax: 904-621-9924
Mailing address:
  • Phone: 877-521-1333
  • Fax: 904-621-9924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State

VIII. Authorized Official

Name: DAVID MICHAEL BROEDERDORF
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 877-521-1333