Provider Demographics
NPI:1649280553
Name:FRENKEL, RONALD ERIC PRENTIS (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:ERIC PRENTIS
Last Name:FRENKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 896
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34995-0896
Mailing Address - Country:US
Mailing Address - Phone:772-287-9000
Mailing Address - Fax:772-287-0507
Practice Address - Street 1:509 SE RIVERSIDE DR
Practice Address - Street 2:SUITE 302
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2579
Practice Address - Country:US
Practice Address - Phone:772-287-9000
Practice Address - Fax:772-287-0507
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME51202207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL07791OtherBCBS OF FLORIDA
5044106OtherCCN
180007295OtherRAILROAD MEDICARE NUMBER
1984148OtherFIRST HEALTH
5044106OtherCCN
B76315Medicare UPIN