Provider Demographics
NPI:1619597713
Name:FRANKLIN, JAMES RONALD JR (RBT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RONALD
Last Name:FRANKLIN
Suffix:JR
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12974 SW 251ST TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-5787
Mailing Address - Country:US
Mailing Address - Phone:305-815-0792
Mailing Address - Fax:
Practice Address - Street 1:12974 SW 251ST TER
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-5787
Practice Address - Country:US
Practice Address - Phone:305-815-0792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020034200Medicaid