Organization
FLAGLER FAMILY MEDICINE P A
Active
Other names
Northeast Florida Foot and Ankle
Organization subpart
No
Provider details
NPI number
Authorized official
WARREN WHITLOCK MD (AUTHORIZED OFFICIAL / PARTNER)
(904) 826-3469
Entity
Organization
Contact information
Practice address
52 TUSCAN WAY STE 205, ST AUGUSTINE, FL 32092-1850
(904) 826-3469
Mailing address
130 HEALTH PARK BLVD, ST AUGUSTINE, FL 32086-5776
(904) 826-3469
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252488100
—
FL
Enumeration date
07/20/2018
Last updated
07/20/2018
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