Healthcare Provider Details

I. General information

NPI: 1801957402
Provider Name (Legal Business Name): KENNETH EMANUEL FRANCUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 06/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5481 W WATERS AVE STE 111
TAMPA FL
33634
US

IV. Provider business mailing address

5816 STONECREST DR
AGOURA HILLS CA
91301-4625
US

V. Phone/Fax

Practice location:
  • Phone: 360-513-9665
  • Fax:
Mailing address:
  • Phone: 818-597-8185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberG59467
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberG59467
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberME136664
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberME136664
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: