Organization
FLAGLER COUNTY PUBLIC SCHOOLS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARTHA FERNANDA VICOSO (MEDICAID SUPPORT TECHNICIAN)
(386) 586-2395
Entity
Organization
Contact information
Practice address
1769 EAST MOODY BOULEVARD, BUILDING 2, BUNNELL, FL 32110-0755
(386) 586-2395
(386) 586-2388
Mailing address
1769 EAST MOODY BOULEVARD, BUILDING 2, PO BOX 755, BUNNELL, FL 32100-0755
(386) 586-2395
(386) 586-2388
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008032201
—
FL
05
—
008032215
—
FL
05
—
008032217
—
FL
05
—
008032218
—
FL
Enumeration date
02/23/2007
Last updated
06/26/2008
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