Provider Demographics
NPI:1093758955
Name:FLANAGAN, EILEEN M (PA)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:M
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:2815 S SEACREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7934
Mailing Address - Country:US
Mailing Address - Phone:561-364-2689
Mailing Address - Fax:561-364-2689
Practice Address - Street 1:4801 S CONGRESS AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-4746
Practice Address - Country:US
Practice Address - Phone:561-967-6500
Practice Address - Fax:561-963-5600
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-05-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA 9101861363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP14540Medicare UPIN