Provider Demographics
NPI:1659410868
Name:FRANKLIN FIEDELHOLTZ MD PA
Entity Type:Organization
Organization Name:FRANKLIN FIEDELHOLTZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FIEDELHOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PA
Authorized Official - Phone:305-933-1424
Mailing Address - Street 1:21110 BISCAYNE BLVD.
Mailing Address - Street 2:SUITE # 208
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180
Mailing Address - Country:US
Mailing Address - Phone:305-933-1424
Mailing Address - Fax:305-933-2231
Practice Address - Street 1:21110 BISCAYNE BLVD.
Practice Address - Street 2:SUITE # 208
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180
Practice Address - Country:US
Practice Address - Phone:305-933-1424
Practice Address - Fax:305-933-2231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0015048207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370160300Medicaid
FL370160300Medicaid
91002Medicare PIN