Provider Demographics
NPI:1154687507
Name:ACLOQUE, GERARD FRANTZ JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:FRANTZ
Last Name:ACLOQUE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5555 HOLLYWOOD BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6420
Mailing Address - Country:US
Mailing Address - Phone:954-932-3269
Mailing Address - Fax:
Practice Address - Street 1:5555 HOLLYWOOD BLVD STE 201
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6420
Practice Address - Country:US
Practice Address - Phone:954-932-3269
Practice Address - Fax:954-405-8477
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL128734207R00000X
FLME128734207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine