Provider Demographics
NPI:1487244000
Name:FLANAGAN, CHERI ANN (PT)
Entity type:Individual
Prefix:
First Name:CHERI
Middle Name:ANN
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 LOVE CT NW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-9489
Mailing Address - Country:US
Mailing Address - Phone:316-518-7844
Mailing Address - Fax:
Practice Address - Street 1:1350 MALABAR RD SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-3406
Practice Address - Country:US
Practice Address - Phone:321-345-4224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT33596225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist