Healthcare Provider Details

I. General information

NPI: 1508062969
Provider Name (Legal Business Name): FLAGLER HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 07/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HEALTH PARK BLVD
ST AUGUSTINE FL
32086-5784
US

IV. Provider business mailing address

400 HEALTH PARK BLVD
ST AUGUSTINE FL
32086-5784
US

V. Phone/Fax

Practice location:
  • Phone: 904-819-5155
  • Fax: 904-819-4906
Mailing address:
  • Phone: 904-819-5155
  • Fax: 904-819-4906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number StateFL

VIII. Authorized Official

Name: MELISSA LANZER
Title or Position: PATIENT FINANCIAL SERVICES
Credential:
Phone: 904-819-4529