Provider Demographics
NPI:1700227105
Name:FRANTZ, DAVID CHARLES
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:CHARLES
Last Name:FRANTZ
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 1:13250 RIDGE RD
Mailing Address - Street 2:APT. 4A1
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-1856
Mailing Address - Country:US
Mailing Address - Phone:941-565-7666
Mailing Address - Fax:
Practice Address - Street 1:13250 RIDGE RD
Practice Address - Street 2:APT 4A1
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-1856
Practice Address - Country:US
Practice Address - Phone:941-565-7666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-13
Last Update Date:2013-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPSI28823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist