Mrs Lorraine C Flock, RDN, CDE | |
1715 Buchanan St, Hollywood, FL 33020-4029 | |
(954) 547-7771 | |
Not Available |
Full Name | Mrs Lorraine C Flock |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 1715 Buchanan St, Hollywood, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1457730103 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | ND2694 (Florida) | Primary |
Provider Name | Glutality Provider Group Pa |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1083256168 PECOS PAC ID: 9032549837 Enrollment ID: O20200419000189 |
Mailing Address | Practice Location Address |
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Mrs Lorraine C Flock, RDN, CDE 1715 Buchanan St, Hollywood, FL 33020-4029 Ph: (954) 547-7771 | Mrs Lorraine C Flock, RDN, CDE 1715 Buchanan St, Hollywood, FL 33020-4029 Ph: (954) 547-7771 |
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