Provider Demographics
NPI:1063949253
Name:FLAGLER MEDICAL CENTER INC
Entity type:Organization
Organization Name:FLAGLER MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IVO
Authorized Official - Middle Name:
Authorized Official - Last Name:MIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-334-5409
Mailing Address - Street 1:175 FONTAINEBLEAU BLVD STE 1F1
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4672
Mailing Address - Country:US
Mailing Address - Phone:786-334-5409
Mailing Address - Fax:786-334-6721
Practice Address - Street 1:175 FONTAINEBLEAU BLVD STE 1F1
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4672
Practice Address - Country:US
Practice Address - Phone:786-334-5409
Practice Address - Fax:786-334-6721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty