Provider Demographics
NPI:1619216454
Name:FLASHENBURG, JUANITA KLIM (FNP)
Entity Type:Individual
Prefix:
First Name:JUANITA
Middle Name:KLIM
Last Name:FLASHENBURG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JUANITA
Other - Middle Name:RAQUEL
Other - Last Name:KLIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:12109 COUNTY ROAD 103
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:FL
Mailing Address - Zip Code:34484-2951
Mailing Address - Country:US
Mailing Address - Phone:352-205-8981
Mailing Address - Fax:
Practice Address - Street 1:430 MORTON PLANT ST STE 206
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3396
Practice Address - Country:US
Practice Address - Phone:727-441-1508
Practice Address - Fax:727-443-7780
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11007845363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner