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General NPI Number Information
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NPI Number | 1053584144
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Entity Type | Organization
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Legal Business Name | FLYNN CLINIC, INC
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 04/30/2010
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Provider Practice Location Address
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Address Line | 3810 S FLORIDA AVE
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City | LAKELAND
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State | FL
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Zip | 33813-1105
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Country | US
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Telephone | 863-646-5111
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Fax |
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Provider Business Mailing Address
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Address Line | 3810 S FLORIDA AVE
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City | LAKELAND
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State | FL
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Zip | 33813-1105
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Country | US
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Telephone | 863-646-5111
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | WENDY LYNN SCHWEITZ FLYNN
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Credential | DC
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Telephone | 863-398-4114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | FL
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