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General NPI Number Information
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NPI Number | 1801926837
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Entity Type | Organization
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Legal Business Name | FLAGLER COUNTY PUBLIC SCHOOLS
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1769 EAST MOODY BOULEVARD, BUILDING 2
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City | BUNNELL
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State | FL
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Zip | 32110-0755
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Country | US
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Telephone | 386-437-7526
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Fax | 386-586-2388
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Provider Business Mailing Address
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Address Line | 1769 EAST MOODY BOULEVARD, BUILDING 2
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City | BUNNELL
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State | FL
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Zip | 32110-0755
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Country | US
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Telephone | 386-437-7526
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Fax | 386-586-2388
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Authorized Official
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Title or Position | MEDICAID SUPPORT TECHNICIAN
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Name | MRS. MARTHA FERNANDA VICOSO
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Credential |
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Telephone | 386-437-7526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | FL
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