Healthcare Provider Details

I. General information

NPI: 1235282815
Provider Name (Legal Business Name): FRANKLIN PIMENTEL SR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 PONCE DE LEON BLVD SUITE # 408
CORAL GABLES FL
33134-2049
US

IV. Provider business mailing address

747 PONCE DE LEON BLVD SUITE # 408
CORAL GABLES FL
33134-2049
US

V. Phone/Fax

Practice location:
  • Phone: 305-445-0700
  • Fax: 305-447-1638
Mailing address:
  • Phone: 305-445-0700
  • Fax: 305-447-1638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME 51304
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME0051304
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberME 51304
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: