Provider Demographics
NPI:1003475567
Name:FRANCO, JUANA
Entity Type:Individual
Prefix:
First Name:JUANA
Middle Name:
Last Name:FRANCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3297 SE COUNTY ROAD 252
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-3895
Mailing Address - Country:US
Mailing Address - Phone:386-628-7776
Mailing Address - Fax:
Practice Address - Street 1:3297 SE COUNTY ROAD 252
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-3895
Practice Address - Country:US
Practice Address - Phone:386-628-7776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL236089372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion