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General NPI Number Information
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NPI Number | 1679741391
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Entity Type | Organization
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Legal Business Name | DEBORAH C FLANAGAN OD PA
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 05/14/2010
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Provider Practice Location Address
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Address Line | 4940 CENTRAL AVE
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City | ST PETERSBURG
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State | FL
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Zip | 33707-1941
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Country | US
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Telephone | 727-321-6600
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Fax | 727-321-8300
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Provider Business Mailing Address
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Address Line | 4940 CENTRAL AVE
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City | ST PETERSBURG
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State | FL
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Zip | 33707-1941
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Country | US
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Telephone | 727-321-6600
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Fax | 727-321-8300
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Authorized Official
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Title or Position | OPTOMETRIC PHYSICIAN
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Name | DR. DEBORAH C FLANAGAN
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Credential | OD
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Telephone | 727-321-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OPC1713
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License Number State | FL
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