Provider Demographics
NPI:1679172779
Name:FLAGLER FAMILY NURSING HOME CARE LLC
Entity Type:Organization
Organization Name:FLAGLER FAMILY NURSING HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUB
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:904-826-3469
Mailing Address - Street 1:130 HEALTHPARK BLVD
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-5776
Mailing Address - Country:US
Mailing Address - Phone:904-826-3469
Mailing Address - Fax:904-679-3169
Practice Address - Street 1:130 HEALTHPARK BLVD
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5776
Practice Address - Country:US
Practice Address - Phone:904-826-3469
Practice Address - Fax:904-679-3169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty