Provider Demographics
NPI:1417164252
Name:FLINT, DANA LYNN (CPTH)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:LYNN
Last Name:FLINT
Suffix:
Gender:F
Credentials:CPTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2773 REGAL LN
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-7572
Mailing Address - Country:US
Mailing Address - Phone:407-678-4241
Mailing Address - Fax:
Practice Address - Street 1:3796 HOWELL BRANCH RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792
Practice Address - Country:US
Practice Address - Phone:407-915-3360
Practice Address - Fax:407-386-3082
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL260101030757491183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102786700Medicaid