Individual
DR. SUSAN D FLAGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2572 COMMERCE PKWY, NORTH PORT, FL 34289-9356
(941) 429-3545
(941) 429-3546
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
3757
IA
208000000X
Pediatrics Physician
381
NE
208000000X
Pediatrics Physician
Primary
OS 10992
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021026500
—
FL
05
—
0579250
—
IA
01
—
149Q6
BCBS
FL
05
—
1579250
—
IA
01
—
27579
WELLMARK BLUE SHIELD
IA
01
—
32137
WELLMARK BLUE SHIELD
IA
01
—
IK203Y
MEDICARE
FL
Enumeration date
08/17/2006
Last updated
08/25/2020
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