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NPI Code Detail

MEDICARE: MYRON FRANKLIN OTR/L

MEDICARE:   MYRON  FRANKLIN  OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171W00000XContractor273555085FL

General Provider Information

NPI Number : 1043578107
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYRON FRANKLIN OTR/L
Provider Business Mailing Address
First Line : 5042 PERSIMMON HOLLOW RD
Second Line :
City : MILTON
State : FL
Zip : 32583-2739
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 69 BAY BRIDGE DR
Second Line :
City : GULF BREEZE
State : FL
Zip : 32561-4468
Country : US
Telephone Number : 850-221-7090
Fax Number : 877-848-1329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2012
Last Update Date : 04/26/2012

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Directions to “ MYRON FRANKLIN OTR/L” Practice Location

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