Flack, Charles Edward
Flack, Charles Edward is an sole proprietor health care provider with primary practice located at 10301 Hagen Ranch Rd Suite C130, Boynton Beach FL 33437. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Urology, which is considered as his primary health care specialty. Flack, Charles Edward can be contacted via phone (561) 736-7313.Contact Information
Primary practice address
10301 Hagen Ranch Rd Suite C130
Boynton Beach FL 33437
Phone: (561) 736-7313
Fax: (561) 736-2309
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Urology | 2088P0231X | ME59937 | Florida |
| Allopathic & Osteopathic Physicians / Pediatric Urology | 2088P0231X | TP103 | Kentucky |
| Allopathic & Osteopathic Physicians / Pediatric Urology | 2088P0231X | 0101273176 | Virginia |
Profile Details
| NPI number | 1497729727 |
|---|---|
| LBN Legal business name | Flack, Charles Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 14th, 2006 |
| Last updated | Sep 12th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497729727 | NPPES |
| Florida | Other | 204200 | AMERIGROUP |
| Florida | Other | 5962 | AMERIGROUP |
| Florida | MEDICAID | 054273300 | AMERIGROUP |
| Florida | Other | 103690 | AMERIGROUP |
| Florida | Other | 12475 | AMERIGROUP |
| Florida | Other | 1755943 | AMERIGROUP |
| Florida | Other | 26943 | AMERIGROUP |
| Florida | Other | 4611456 | AMERIGROUP |
| Florida | Other | 2032607 | AMERIGROUP |
| Florida | Other | 26943 | AMERIGROUP |
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