MEDICARE: FRANTZ DESAMOUR

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
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1144843475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANTZ DESAMOUR

Provider Business Mailing Address
First Line	:	323 IVES DAIRY RD APT 2
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-3348
Country	:	US
Telephone Number	:	786-344-1034
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 NW 183RD ST STE 202
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-4578
Country	:	US
Telephone Number	:	786-344-1034
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2020
Last Update Date	:	05/20/2020

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Directions to “ FRANTZ DESAMOUR ” Practice Location

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