CHARLES EDWARD FLACK (NPI# 1497729727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497729727 |
| Entity Type | Individual |
| Full Name | CHARLES EDWARD FLACK |
| Credential | MD |
| Practice Address |
10301 Hagen Ranch Rd Suite C130 Boynton Beach FL 33437 |
| Mailing Address |
1300 Sawgrass Corporate Pkwy Ste 200 Sunrise FL 33323-2823 |
| Practice Telephone | 5617367313 |
| Practice Fax Number | 5617362309 |
| Mailing Telephone | 8002433839 |
| Mailing Fax Number | 8555275510 |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2017-11-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2088P0231X |
Urology Specialization: Pediatric Urology |
ME59937 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | WELLCARE | 26943 | 01 |
| FL | AMERIGROUP | 204200 | 01 |
| FL | STAYWELL | 26943 | 01 |
| FL | AETNA NON-HMO | 4611456 | 01 |
| FL | BCBS | 12475 | 01 |
| FL | NHP | 5962 | 01 |
| FL | AETNA HMO | 2032607 | 01 |
| FL | AVMED | 103690 | 01 |
| FL | CIGNA | 1755943 | 01 |
| FL | 054273300 | 05 |
| Street Address |
10301 HAGEN RANCH RD SUITE C130 |
| City | BOYNTON BEACH |
| State | FL |
| Zip Code | 33437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578557989 | William S. Berman, M.d., P.a. | Specialist | 10301 Hagen Ranch Rd, Suite 3, Boynton Beach, FL 33437-3724 | 2005-08-31 |
| 1285263749 | Camille Marie Sharkey | Nurse Practitioner | 10301 Hagen Ranch Rd, Boynton Beach, FL 33437-3724 | 2020-04-06 |
| 1245650720 | Lawrence S. Amesse Md, Pa | Obstetrics & Gynecology | 10301 Hagen Ranch Rd, Suite 6, Boynton Beach, FL 33437-3724 | 2014-04-23 |
| 1881021947 | Atlantic Reproductive Associates, LLC | Clinic/Center | 10301 Hagen Ranch Rd, Suite 6, Boynton Beach, FL 33437-3724 | 2013-10-03 |
| 1649607136 | Jilleen M. Pannozzo, D.o., P.a. | Psychiatry & Neurology | 10301 Hagen Ranch Rd, Suite 7, Boynton Beach, FL 33437-3724 | 2013-09-30 |
| 1255771200 | Elizabeth Ronan Sheldon | Nurse Practitioner | 10301 Hagen Ranch Rd, Suite A920, Boynton Beach, FL 33437-3724 | 2013-07-04 |
| 1306281910 | Your Beautiful Smile, LLC | Dentist | 10301 Hagen Ranch Rd, Suite C140, Boynton Beach, FL 33437-3724 | 2013-05-09 |
| 1952660425 | Melanie Lynne Burke | Obstetrics & Gynecology | 10301 Hagen Ranch Rd, Suite B740, Boynton Beach, FL 33437-3724 | 2012-05-03 |
| 1083924963 | Allison Hock Cassedy | Physician Assistant | 10301 Hagen Ranch Rd, Boynton Beach, FL 33437-3724 | 2010-10-13 |
| 1861709974 | Kristen Zoppi | Physician Assistant | 10301 Hagen Ranch Rd, Boynton Beach, FL 33437-3724 | 2010-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548800808 | Ortho Florida, LLC | Anesthesiology | 11135 S Jog Road Ste 5, Boynton Beach, FL 33437 | 2020-01-14 |
| 1730725086 | Uttamkumar Sheladiya | Pharmacist | 12080 South Jog Rod, Boyton Beach, FL 33437 | 2019-11-21 |
| 1831601608 | Sheri Keehn | Nurse Practitioner | 6713 Conch Ct, Boynton Beach, FL 33437 | 2017-11-01 |
| 1265958037 | Kiersten Lutchi | Behavior Technician | 7862 Red Mahogany Road, Boynton Beach, FL 33437 | 2017-08-14 |
| 1740725084 | Marie Maxi | Behavior Technician | 6713 Heritage Grande, 1206, Boynton Beach, FL 33437 | 2016-12-22 |
| 1184071623 | Darronique Johnson | Technician, Other | 10779 Cambay Cr., Boynton Beach, FL 33437 | 2016-05-14 |
| 1033580709 | Brett R. Hutton, M.d., P.a. | Internal Medicine | 10301 Hagen Ranch Rd Ste B550, Boynton Beach, FL 33437 | 2015-10-07 |
| 1104258417 | Domenick Andrew Cerullo | Dentist | 10150 Hagen Ranch Road Suite 202, Dental Arts of Boynton Beach, P.a., Boynton Beach, FL 33437 | 2013-08-09 |
| 1275883399 | Kate A Vazquez | Physician Assistant | 7593 Boynton Beach Blvd Ste 190, Boynton Beach, FL 33437 | 2012-09-17 |
| 1912256009 | Kristi Joy Kline | Physical Therapist | 11135 South Jog Road, Suite 1, Boynton Beach, FL 33437 | 2012-09-05 |
| Find all providers in zip 33437 | ||||
| Taxonomy Code | 2088P0231X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Pediatric Urology |
| Surgeons who can diagnose, treat, and manage children’s urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). |
| Notes: Source: American Academy of Pediatrics [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053357913 | Andrew S Labbie | Urology | 3200 Sw 60th Ct Ste 104, Miami, FL 33155-4069 | 2006-06-21 |
| 1407842701 | Mark E Kolligian | Urology | 4712 N Armenia Ave, Suite 200, Tampa, FL 33603-2611 | 2005-09-22 |
| 1295277911 | Florida Urology Specialists LLC | Urology | 1 S School Ave, Suite 200, Sarasota, FL 34237-6014 | 2016-11-11 |
| 1225438666 | Mariarita Salvitti | Urology | 3200 Sw 60th Ct, Suite 104, Miami, FL 33155-4000 | 2014-09-03 |
| 1851717151 | Alireza Alam | Urology | 3200 Sw 60th Ct Ste 104, Miami, FL 33155-4069 | 2014-03-11 |
| 1659718989 | George Ransford | Urology | 3100 Sw 62nd Ave, Miami, FL 33155 | 2013-05-28 |
| 1376834820 | Diana Cardona-grau | Urology | 1725 Cook Ave, Orlando, FL 32806-2911 | 2011-05-02 |
| 1487951554 | Natalia Ballesteros | Urology | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2011-02-24 |
| 1588965909 | Karl Sturge M.d. P.a. | Urology | 9299 Sw 152nd Street, Suite 205, Miami, FL 33157 | 2010-11-17 |
| 1295049138 | John P Adams Md Pa | Urology | 200 Doctors Dr, Panama City, FL 32405-4559 | 2010-08-03 |
| Find all providers with the same taxonomy | ||||
| City | BOYNTON BEACH |
| Zip Code | 33437 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.