Healthcare Provider Details

I. General information

NPI: 1801652045
Provider Name (Legal Business Name): FRANK JOHN IANNOTTI CEP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 NORTH UNIVERSITY DRIVE
CORAL SPRINGS FL
33067
US

IV. Provider business mailing address

5701 NORTH UNIVERSITY DRIVE
CORAL SPRINGS FL
33067
US

V. Phone/Fax

Practice location:
  • Phone: 954-518-7500
  • Fax: 954-518-7501
Mailing address:
  • Phone: 954-518-7500
  • Fax: 954-518-7501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number632486
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: