MEDICARE: DR. FRANK J CERVONE D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	9098	FL

General Provider Information

NPI Number	:	1598778037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK J CERVONE D.M.D.

Provider Business Mailing Address
First Line	:	474 JACKSONVILLE DR
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-3812
Country	:	US
Telephone Number	:	904-241-1544
Fax Number	:	904-241-1730

Provider Business Practice Location Address
First Line	:	474 JACKSONVILLE DR
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-3812
Country	:	US
Telephone Number	:	904-241-1544
Fax Number	:	904-241-1730

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	07/08/2007

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