Provider Demographics
NPI:1407247232
Name:FRANK CUSTURERI MD
Entity Type:Organization
Organization Name:FRANK CUSTURERI MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNERPHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:VICTOR
Authorized Official - Last Name:CUSTURERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-329-5076
Mailing Address - Street 1:3355 BURNS RD STE 206
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4356
Mailing Address - Country:US
Mailing Address - Phone:561-627-3818
Mailing Address - Fax:561-627-3835
Practice Address - Street 1:3355 BURNS RD STE 206
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4356
Practice Address - Country:US
Practice Address - Phone:561-627-3818
Practice Address - Fax:561-627-3835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL034912261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center