Provider Demographics
NPI:1538130760
Name:FRANCHINO, CHARLES JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:JOSEPH
Last Name:FRANCHINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S ANDREWS AVE STE 1090
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2510
Mailing Address - Country:US
Mailing Address - Phone:954-384-2727
Mailing Address - Fax:724-287-2730
Practice Address - Street 1:1600 S ANDREWS AVE STE 1090
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2510
Practice Address - Country:US
Practice Address - Phone:954-523-2727
Practice Address - Fax:954-523-8814
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD046734L2084P0800X
FLME1296332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA007213720Medicaid
PA0072137270004Medicaid
G19543Medicare UPIN
PA007213720Medicaid