Provider Demographics
NPI:1598507014
Name:FLAGLER PROFESSIONAL HEALTH CARE SERVICES, INC.
Entity type:Organization
Organization Name:FLAGLER PROFESSIONAL HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARLTON
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVOOGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-819-4088
Mailing Address - Street 1:70 TURIN TERRACE, SUITE 110
Mailing Address - Street 2:
Mailing Address - City:ST. AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092
Mailing Address - Country:US
Mailing Address - Phone:904-819-7200
Mailing Address - Fax:
Practice Address - Street 1:70 TURIN TERRACE, SUITE 110
Practice Address - Street 2:
Practice Address - City:ST. AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092
Practice Address - Country:US
Practice Address - Phone:904-819-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLAGLER PROFESSIONAL HEALTH CARE SERV
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care