Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | ME122820 | FL |
NPI | 1336350446 |
---|---|
Provider Name | Amy Alicia Flick |
First Address | Pembroke Pines, FL 33027-1207 |
Second Address | Pembroke Pines, FL 33027-1207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 20/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A1084150 | (05) | CA |