Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 11003782 | FL |
NPI | 1316595960 |
---|---|
Provider Name | Frantz Pierre |
First Address | Lake Worth, FL 33463-7485 |
Second Address | Palm Springs, FL 33461-2169 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2019 |
Last Update Date | 27/08/2019 |