Provider Demographics
NPI:1063139350
Name:FLIEHMAN, CODY
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:FLIEHMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8121 PORT SAID ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-1517
Mailing Address - Country:US
Mailing Address - Phone:813-476-3607
Mailing Address - Fax:
Practice Address - Street 1:3550 N GOLDENROD RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-8823
Practice Address - Country:US
Practice Address - Phone:813-476-3607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH22774101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health