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General NPI Number Information
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NPI Number | 1497361034
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Entity Type | Individual
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Provider Name | JENNIFER FLICK
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Gender | Female
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Dates
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Enumeration Date | 09/18/2020
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 3920 BEE RIDGE RD UNIT F
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City | SARASOTA
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State | FL
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Zip | 34233-1207
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Country | US
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Telephone | 941-484-6758
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Fax | 941-404-4451
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Provider Business Mailing Address
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Address Line | 600 BIRD BAY DR W
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City | VENICE
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State | FL
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Zip | 34285-8020
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Country | US
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Telephone | 941-782-0505
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Fax | 833-753-3297
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11009096
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN1109096
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License Number State | FL
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