Provider Demographics
NPI:1013342922
Name:FRANK P CASERTA MD PC
Entity Type:Organization
Organization Name:FRANK P CASERTA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:P
Authorized Official - Last Name:CASERTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-967-3381
Mailing Address - Street 1:2600 S. RURAL RD SUITE B
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-2448
Mailing Address - Country:US
Mailing Address - Phone:480-967-3381
Mailing Address - Fax:480-967-0755
Practice Address - Street 1:2600 S RURAL RD SUITE B
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-2448
Practice Address - Country:US
Practice Address - Phone:480-967-3381
Practice Address - Fax:480-967-0755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-10
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ25755174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty