Provider Demographics
NPI:1962849075
Name:FRANKLIN, KEVIN SCOTT
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:SCOTT
Last Name:FRANKLIN
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 1:529 S PARSONS AVE
Mailing Address - Street 2:APT 611
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-6069
Mailing Address - Country:US
Mailing Address - Phone:813-952-6428
Mailing Address - Fax:
Practice Address - Street 1:207 E ROBERTSON ST
Practice Address - Street 2:D
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5254
Practice Address - Country:US
Practice Address - Phone:813-952-6428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 66351225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist