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General NPI Number Information
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NPI Number | 1891207551
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Entity Type | Organization
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Legal Business Name | FLAGLER PROFESSIONAL HEALTH CARE SERVICES, INC.
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Dates
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Enumeration Date | 11/02/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3901 UNIVERSITY BLVD S STE 221
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4392
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Country | US
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Telephone | 904-423-0010
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Fax | 904-423-0012
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Provider Business Mailing Address
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Address Line | 301 HEALTH PARK BLVD STE 101
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-5794
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Country | US
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Telephone | 904-819-4400
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Fax | 904-819-4472
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JASON PAUL BARRETT
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Credential |
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Telephone | 904-819-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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