Provider Demographics
NPI:1235983826
Name:FLOWLY HEALTH MEDICAL GROUP P.A.
Entity Type:Organization
Organization Name:FLOWLY HEALTH MEDICAL GROUP P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MSO CEO
Authorized Official - Prefix:
Authorized Official - First Name:CELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-889-1132
Mailing Address - Street 1:390 NE 191ST ST STE 8264
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3899
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:390 NE 191ST ST STE 8264
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-3899
Practice Address - Country:US
Practice Address - Phone:323-545-3659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty