Healthcare Provider Details

I. General information

NPI: 1275637589
Provider Name (Legal Business Name): JAY CONRAD FRANKLIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2006
Last Update Date: 05/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8525 SW 92ND ST SUITE D14
MIAMI FL
33156
US

IV. Provider business mailing address

8525 SW 92ND ST SUITE D14
MIAMI FL
33156
US

V. Phone/Fax

Practice location:
  • Phone: 305-271-4904
  • Fax: 305-274-9810
Mailing address:
  • Phone: 305-271-4904
  • Fax: 305-274-9810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME15877
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: