=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932331832
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANTZ ANTOINE OTR
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2009
-----------------------------------------------------
Last Update Date | 08/12/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6152 VERDE TRL N
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33433-2430
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-215-9657
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5613 PACIFIC BLVD 3303
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33433-6730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-215-9657
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OT13456
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------