Provider Demographics
NPI:1043416696
Name:FRANGOS, JENNIFER A (DO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:A
Last Name:FRANGOS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:HONAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:123 W 18TH ST FL 8
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-4127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4500 N STATE ROAD 7 STE 102
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-5868
Practice Address - Country:US
Practice Address - Phone:561-476-0060
Practice Address - Fax:888-806-0629
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2122204D00000X, 207Q00000X
IL036144558207Q00000X
OH34011609207Q00000X
MI5101024644207Q00000X
FLOS16054207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0090671Medicaid
WV3810009870Medicaid
WV3810009870Medicaid