Provider Demographics
NPI:1467057992
Name:GUILLAUME, FRANCKLIN
Entity Type:Individual
Prefix:
First Name:FRANCKLIN
Middle Name:
Last Name:GUILLAUME
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 BRANDON PRESCOTT LN APT 205
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-8712
Mailing Address - Country:US
Mailing Address - Phone:786-223-8893
Mailing Address - Fax:
Practice Address - Street 1:755 BRANDON PRESCOTT LN APT 205
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-8712
Practice Address - Country:US
Practice Address - Phone:786-223-8893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X, 376J00000X
FLPN5225428164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty