1164619227 NPI number — JON FRANKEL MD PA

Table of content: (NPI 1164619227)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164619227 NPI number — JON FRANKEL MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JON FRANKEL MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DIAGNOSTIC PATHOLOGY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164619227
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/14/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5130 S POINTE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INVERNESS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34450-7405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-344-8641
Provider Business Mailing Address Fax Number:
352-344-8641

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5130 S POINTE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INVERNESS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34450-7405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-344-8641
Provider Business Practice Location Address Fax Number:
352-344-8641
Provider Enumeration Date:
10/02/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FRANKEL
Authorized Official First Name:
JON
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
352-344-8641

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X , with the licence number:  ME0044457 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CI3049 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 254407500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".