Provider Demographics
NPI:1619638749
Name:FLORENDO, FRANKLIN G
Entity Type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:G
Last Name:FLORENDO
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 1:4120 BUFFALO BILL AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-3293
Mailing Address - Country:US
Mailing Address - Phone:702-403-6581
Mailing Address - Fax:
Practice Address - Street 1:4120 BUFFALO BILL AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-3293
Practice Address - Country:US
Practice Address - Phone:702-403-6581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant