Provider Demographics
NPI:1174037378
Name:VIXAMAR, FRANKLIN MARCELIN SR
Entity Type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:MARCELIN
Last Name:VIXAMAR
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 W EVANSTON CIR
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-1817
Mailing Address - Country:US
Mailing Address - Phone:646-234-5155
Mailing Address - Fax:
Practice Address - Street 1:520 W EVANSTON CIR
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-1817
Practice Address - Country:US
Practice Address - Phone:646-234-5155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other