Provider Demographics
NPI:1982669453
Name:FLANAGAN, DEBORAH CLOWERS (OD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:CLOWERS
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4940 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-1941
Mailing Address - Country:US
Mailing Address - Phone:727-321-6600
Mailing Address - Fax:727-321-8300
Practice Address - Street 1:4940 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-1941
Practice Address - Country:US
Practice Address - Phone:727-321-6600
Practice Address - Fax:727-321-8300
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1713152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL078307200Medicaid
FLT54786Medicare UPIN
FL078307200Medicaid