Provider Demographics
NPI:1356432090
Name:KOHLER, FRANK R JR (DO)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:R
Last Name:KOHLER
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1667 N CLYDE MORRIS BLVD.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-5550
Mailing Address - Country:US
Mailing Address - Phone:386-274-4840
Mailing Address - Fax:386-274-2215
Practice Address - Street 1:1667 N CLYDE MORRIS BLVD STE 2
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-5500
Practice Address - Country:US
Practice Address - Phone:386-274-4840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14477207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
107SDOtherFLORIDA BLUE
GA202I115215Medicare PIN
VAF64189Medicare UPIN
VA010007810Medicaid
VA017652J34Medicare PIN