Provider Demographics
NPI:1548817356
Name:FLYNN, PATRICIA JEAN
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JEAN
Last Name:FLYNN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28229 COUNTY ROAD 33 LOT W205
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-4587
Mailing Address - Country:US
Mailing Address - Phone:352-408-6765
Mailing Address - Fax:352-365-0355
Practice Address - Street 1:28229 COUNTY ROAD 33 LOT W205
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-4587
Practice Address - Country:US
Practice Address - Phone:352-408-6765
Practice Address - Fax:352-365-0344
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant