Provider Demographics
NPI:1326030966
Name:CIRISANO, FRANK DOMINIC JR (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:DOMINIC
Last Name:CIRISANO
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:PO BOX 7957
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33482-7957
Mailing Address - Country:US
Mailing Address - Phone:561-447-0090
Mailing Address - Fax:561-447-9663
Practice Address - Street 1:5280 LINTON BLVD STE 216
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6516
Practice Address - Country:US
Practice Address - Phone:561-447-0090
Practice Address - Fax:561-447-9663
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0074132207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL25417260Medicaid
FL42726XMedicare PIN
FL42726WMedicare PIN
FL25417260Medicaid