Healthcare Provider Details

I. General information

NPI: 1225297559
Provider Name (Legal Business Name): RENE FRANCO-ELIZONDO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21000 E 12 MILE RD STE 112
SAINT CLAIR SHORES MI
48081-1156
US

IV. Provider business mailing address

5000 W CHAMBERS ST
MILWAUKEE WI
53210-1650
US

V. Phone/Fax

Practice location:
  • Phone: 586-772-5550
  • Fax: 586-772-2470
Mailing address:
  • Phone: 586-314-0080
  • Fax: 877-673-3562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number232552
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMT200455
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMT200455
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number4301096230
License Number StateMI
# 5
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number61389-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: