Provider Demographics
NPI:1841411329
Name:MUSUMECI, FRANK (PT)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:MUSUMECI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18690 NW 2 AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4508
Mailing Address - Country:US
Mailing Address - Phone:305-652-2005
Mailing Address - Fax:305-652-1741
Practice Address - Street 1:18690 NW 2 AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4508
Practice Address - Country:US
Practice Address - Phone:305-652-2005
Practice Address - Fax:305-652-1741
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT5311174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY913EOtherBCBS FACILITY PIN
FLY3900ZMedicare PIN