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General NPI Number Information
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NPI Number | 1780391185
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Entity Type | Individual
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Provider Name | DESMOND FRAZIER
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Gender | Male
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Dates
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Enumeration Date | 11/04/2022
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Last Update Date | 11/04/2022
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Provider Practice Location Address
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Address Line | 5850 S PINE ISLAND RD
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City | DAVIE
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State | FL
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Zip | 33328-5933
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Country | US
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Telephone | 305-501-0231
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Fax |
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Provider Business Mailing Address
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Address Line | 821 NW 85TH TER APT 2211
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City | PLANTATION
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State | FL
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Zip | 33324-1239
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Country | US
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Telephone | 954-734-0939
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT39455
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License Number State | FL
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