Healthcare Provider Details

I. General information

NPI: 1063188571
Provider Name (Legal Business Name): FLOW ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 09/06/2023
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 MARINER BLVD
SPRING HILL FL
34609-5657
US

IV. Provider business mailing address

2333 CORAL HONEYSUCKLE BND APT 308
ODESSA FL
33556-4559
US

V. Phone/Fax

Practice location:
  • Phone: 352-688-0331
  • Fax:
Mailing address:
  • Phone: 203-278-2218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC BRIAN STROUSE
Title or Position: OWNER
Credential: DMD
Phone: 203-278-2218