Provider Demographics
NPI:1730220245
Name:FLINK, FREDERICK F (OD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:F
Last Name:FLINK
Suffix:
Gender:M
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:PO BOX 15517
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-5517
Mailing Address - Country:US
Mailing Address - Phone:850-668-0629
Mailing Address - Fax:
Practice Address - Street 1:3499 THOMASVILLE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-3425
Practice Address - Country:US
Practice Address - Phone:850-894-3710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC001149152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19438Medicare ID - Type Unspecified
T84249Medicare UPIN