MEDICARE: THOMAS K FLANAGAN OD AND ASSOCIATES PA

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	152W00000X	Optometrist	OPC001600	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	410046199	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	19437	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548384522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS K FLANAGAN OD AND ASSOCIATES PA

Provider Business Mailing Address
First Line	:	3322 DR MARTIN LUTHER KING JR ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33704-1212
Country	:	US
Telephone Number	:	727-895-3443
Fax Number	:	727-895-3443

Provider Business Practice Location Address
First Line	:	3322 DR MARTIN LUTHER KING JR ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33704-1212
Country	:	US
Telephone Number	:	727-895-3443
Fax Number	:	727-895-3443

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS K FLANAGAN
Credential	:	OD
Telephone Number	:	727-895-3443

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	04/14/2011

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