Provider Demographics
NPI:1598910226
Name:FLYNN, DANIEL E (PT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:FLYNN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12780 WATERFORD LAKES PKWY
Mailing Address - Street 2:STE 115
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-4500
Mailing Address - Country:US
Mailing Address - Phone:407-207-7188
Mailing Address - Fax:407-207-7103
Practice Address - Street 1:12780 WATERFORD LAKES PKWY
Practice Address - Street 2:STE 115
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4500
Practice Address - Country:US
Practice Address - Phone:407-207-7188
Practice Address - Fax:407-207-7103
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24426225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist