Provider Demographics
NPI:1255304937
Name:COFRESI MEJIA, FRANKLIN R (MD)
Entity Type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:R
Last Name:COFRESI MEJIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FRANKLIN
Other - Middle Name:R
Other - Last Name:COFRESI MEJIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 817737
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33081-1737
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3300 PROVIDENCE DR STE 205
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-561-0030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-11
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90749207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273004900Medicaid
I40225Medicare UPIN
FLU5304ZMedicare ID - Type Unspecified