Healthcare Provider Details

I. General information

NPI: 1124542741
Provider Name (Legal Business Name): FRANKLYN INTERNAL MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2017
Last Update Date: 07/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7201 NORTH UNIVERSITY DR
TAMARAC FL
33321
US

IV. Provider business mailing address

10911 NW 6TH CT
PLANTATION FL
33324
US

V. Phone/Fax

Practice location:
  • Phone: 954-721-2200
  • Fax:
Mailing address:
  • Phone: 518-428-8774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberDR0050287
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME124905
License Number StateFL

VIII. Authorized Official

Name: CAMILLO FRANKLYN
Title or Position: SOLE OWNER
Credential: MD
Phone: 518-428-8774