Provider Demographics
NPI:1962476465
Name:FLENYOL, DALE E (PHD, CRNA)
Entity type:Individual
Prefix:DR
First Name:DALE
Middle Name:E
Last Name:FLENYOL
Suffix:
Gender:F
Credentials:PHD, CRNA
Other - Prefix:DR
Other - First Name:DALE
Other - Middle Name:E
Other - Last Name:FLENYOL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:8427 LAKEVIEW TRL
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-4140
Mailing Address - Country:US
Mailing Address - Phone:954-643-4266
Mailing Address - Fax:954-749-4024
Practice Address - Street 1:8427 LAKEVIEW TRL
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33076
Practice Address - Country:US
Practice Address - Phone:954-643-4266
Practice Address - Fax:954-749-4024
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0129380367500000X
MO2018045390367500000X
FLARNP1936592367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020288300Medicaid
FLG1932TOtherMEDCARE UPN
FLG1932OtherBCBS
FLG1932UOtherMEDICARE PIN
FLG1932YOtherMEDICARE PIN