Provider Demographics
NPI:1235282815
Name:PIMENTEL, FRANKLIN SR (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:
Last Name:PIMENTEL
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE # 408
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2049
Mailing Address - Country:US
Mailing Address - Phone:305-445-0700
Mailing Address - Fax:305-447-1638
Practice Address - Street 1:747 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE # 408
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2049
Practice Address - Country:US
Practice Address - Phone:305-445-0700
Practice Address - Fax:305-447-1638
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 51304207R00000X, 261QP2300X
FLME0051304207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370148400Medicaid
FL07656Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
FLE21390Medicare UPIN