Provider Demographics
NPI:1710417837
Name:ALARCON MARIMON, FRANK (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:ALARCON MARIMON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 NE 124TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5931
Mailing Address - Country:US
Mailing Address - Phone:561-504-3311
Mailing Address - Fax:561-948-2081
Practice Address - Street 1:1100 SW SAINT LUCIE WEST BLVD STE 205
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-1779
Practice Address - Country:US
Practice Address - Phone:772-807-1451
Practice Address - Fax:591-948-2081
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN226601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN22660Medicaid