Healthcare Provider Details

I. General information

NPI: 1962788877
Provider Name (Legal Business Name): MICHAEL PATRICK FLYNN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2011
Last Update Date: 10/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9332 US HIGHWAY 19
PORT RICHEY FL
34668-4772
US

IV. Provider business mailing address

5207 TURQUOISE LN UNIT #105
NEW PORT RICHEY FL
34652-3578
US

V. Phone/Fax

Practice location:
  • Phone: 727-842-3557
  • Fax:
Mailing address:
  • Phone: 585-506-2702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS47998
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: