Provider Demographics
NPI:1770668725
Name:FRANCO, EDEL EDWARD (MD PA)
Entity Type:Individual
Prefix:
First Name:EDEL
Middle Name:EDWARD
Last Name:FRANCO
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 FORBES STREET
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4311
Mailing Address - Country:US
Mailing Address - Phone:904-391-1600
Mailing Address - Fax:904-391-1604
Practice Address - Street 1:2345 FORBES STREET
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4311
Practice Address - Country:US
Practice Address - Phone:904-391-1600
Practice Address - Fax:904-391-1604
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME595542085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12417Medicare ID - Type Unspecified
D76199Medicare UPIN