Provider Demographics
NPI:1235313362
Name:FRANK W. TOUB, M.D.
Entity Type:Organization
Organization Name:FRANK W. TOUB, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:TOUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-428-8326
Mailing Address - Street 1:501 LIVE OAK ST
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-7312
Mailing Address - Country:US
Mailing Address - Phone:386-428-8326
Mailing Address - Fax:386-428-2493
Practice Address - Street 1:501 LIVE OAK ST
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-7312
Practice Address - Country:US
Practice Address - Phone:386-428-8326
Practice Address - Fax:386-428-2493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0053591208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD21180Medicare UPIN
FLK2735Medicare PIN