Provider Demographics
NPI:1568451045
Name:LEPORE, FRANK LOUIS (DPM, MBA)
Entity Type:Individual
Prefix:
First Name:FRANK LOUIS
Middle Name:
Last Name:LEPORE
Suffix:
Gender:M
Credentials:DPM, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 HARBOR BLVD STE 11
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-5038
Mailing Address - Country:US
Mailing Address - Phone:941-500-2088
Mailing Address - Fax:941-500-2089
Practice Address - Street 1:2400 HARBOR BLVD STE 11
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-5038
Practice Address - Country:US
Practice Address - Phone:941-500-2088
Practice Address - Fax:941-500-2089
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005826213E00000X, 213ES0103X, 213ES0131X
FLPO3848213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02209534Medicaid
U86214Medicare UPIN
NY04808Medicare ID - Type UnspecifiedGHI MEDICARE
NY02209534Medicaid
NYPG4411Medicare ID - Type UnspecifiedEMPIRE MEDICARE