Healthcare Provider Details

I. General information

NPI: 1013297670
Provider Name (Legal Business Name): MR. RONALD A FRANCO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2011
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 US 1
MIMS FL
32754-3874
US

IV. Provider business mailing address

2475 US 1
MIMS FL
32754-3874
US

V. Phone/Fax

Practice location:
  • Phone: 321-267-1788
  • Fax:
Mailing address:
  • Phone: 321-267-1788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS44630
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02343700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: