Individual
JOSEPH D. FLYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D. O.
Contact information
Practice address
951 N WASHINGTON AVE, TITUSVILLE, FL 32796-2163
(321) 268-6192
Mailing address
PO BOX 3148, INDIANAPOLIS, IN 46206-3148
(855) 206-8407
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
OS0004494
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
052328300
—
FL
01
—
300040320
RR MEDICARE
FL
05
—
5232830001
—
FL
01
—
80437
BCBS PROVIDER NUMBER
FL
01
—
P00467230
RR MEDICARE
FL
Enumeration date
05/09/2006
Last updated
09/28/2015
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