Provider Demographics
NPI:1538700489
Name:DONATIEN, FRANTZ
Entity Type:Individual
Prefix:
First Name:FRANTZ
Middle Name:
Last Name:DONATIEN
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 1:6213 CALAMARI PL
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-1302
Mailing Address - Country:US
Mailing Address - Phone:813-560-3748
Mailing Address - Fax:
Practice Address - Street 1:6213 CALAMARI PL
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-1302
Practice Address - Country:US
Practice Address - Phone:813-560-3748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver