MEDICARE: FRANTZ JEAN-GUILLAUME MD

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	363AM0700X	Medical Physician Assistant		NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9296468602	OTHER	FL	AMBETTER

General Provider Information

NPI Number	:	1225667553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANTZ JEAN-GUILLAUME MD

Provider Business Mailing Address
First Line	:	766 RICH DR APT 208
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-7866
Country	:	US
Telephone Number	:	954-849-8192
Fax Number	:

Provider Business Practice Location Address
First Line	:	766 RICH DR APT 208
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-7866
Country	:	US
Telephone Number	:	954-849-8192
Fax Number	:

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

Provider Enumeration Date	:	04/07/2020
Last Update Date	:	04/07/2020

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