Provider Demographics
NPI:1871633628
Name:FLINK, PAMELA G (DC)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:G
Last Name:FLINK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 SW TRADITION SQ
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-1934
Mailing Address - Country:US
Mailing Address - Phone:772-344-5914
Mailing Address - Fax:772-344-5915
Practice Address - Street 1:2691 SW PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-2848
Practice Address - Country:US
Practice Address - Phone:772-344-5914
Practice Address - Fax:772-344-5915
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH-7591111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU74387Medicare UPIN
FL55806AMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER