Provider Demographics
NPI:1922603877
Name:FRANKINO, SUSAN POMPHREY
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:POMPHREY
Last Name:FRANKINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3511 NW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3441
Mailing Address - Country:US
Mailing Address - Phone:561-702-0960
Mailing Address - Fax:561-391-5835
Practice Address - Street 1:686 GLADES RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6414
Practice Address - Country:US
Practice Address - Phone:561-395-6132
Practice Address - Fax:561-391-5835
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS20086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty