MEDICARE: DR. GREGORY THOMAS FLYNN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	ME37627	FL

General Provider Information

NPI Number	:	1376595652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY THOMAS FLYNN M.D.

Provider Business Mailing Address
First Line	:	1948 CAROLINA AVE NE
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33703-3410
Country	:	US
Telephone Number	:	813-465-9686
Fax Number	:

Provider Business Practice Location Address
First Line	:	1948 CAROLINA AVE NE
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33703-3410
Country	:	US
Telephone Number	:	813-465-9686
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	12/09/2024

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