Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | ME95736 | FL |
NPI | 1053366021 |
---|---|
Provider Name | Francois Phancao |
First Address | Atlanta, GA 30384-8054 |
Second Address | Miami, FL 33176-2118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 08/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13589 | BLUE CROSS BLUE SHIELD (01) | FL |
307014 | AVMED (01) | FL |