Provider Demographics
NPI:1336287028
Name:FRANKEL, JAY A (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:A
Last Name:FRANKEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 STIRLING RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33024
Mailing Address - Country:US
Mailing Address - Phone:954-436-8326
Mailing Address - Fax:954-433-0603
Practice Address - Street 1:10000 STIRLING RD
Practice Address - Street 2:SUITE 6
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33024
Practice Address - Country:US
Practice Address - Phone:954-436-8326
Practice Address - Fax:954-433-0603
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY2207103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S00011Medicare UPIN
FL75671Medicare ID - Type Unspecified