Provider Demographics
NPI:1184971178
Name:LATINO, FRANK A (PHC)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:A
Last Name:LATINO
Suffix:
Gender:M
Credentials:PHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5510 LOMAS BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-6545
Mailing Address - Country:US
Mailing Address - Phone:505-232-4222
Mailing Address - Fax:505-232-4223
Practice Address - Street 1:5510 LOMAS BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-6545
Practice Address - Country:US
Practice Address - Phone:505-232-4222
Practice Address - Fax:505-232-4223
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPC000002031835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist