Jens Baggesen Flock IV
Surgery, Surgical Critical Care in Daytona Beach, FL. Individual provider (NPI-1).
NPI number1457779803
StatusActive
Last updated in NPPESOct 8, 2020
Details
- NPI
- 1457779803
- Entity type
- Individual (NPI-1)
- Name
- Jens Baggesen Flock IV
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 2, 2014
- Certification date
- Oct 8, 2020
- Last updated
- Oct 8, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0102X | Surgery, Surgical Critical Care | ME146639 | FL | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | 201153 | NC |
Practice location
303 N Clyde Morris BlvdDaytona Beach, FL 32114-2709
Phone 386-425-4000
Mailing address
303 N Clyde Morris BlvdDaytona Beach, FL 32114-2709
Phone 386-425-4000
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