Provider Demographics
NPI:1811260664
Name:FRANKLIN, RIVKAH (PA-C)
Entity type:Individual
Prefix:
First Name:RIVKAH
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:RIVKAH
Other - Middle Name:
Other - Last Name:FISCHWEICHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 S PINE ISLAND RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3920
Mailing Address - Country:US
Mailing Address - Phone:954-315-5784
Mailing Address - Fax:954-522-0755
Practice Address - Street 1:789 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1218
Practice Address - Country:US
Practice Address - Phone:954-315-5784
Practice Address - Fax:954-522-0755
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015337363A00000X
FLPA9108556363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017748600Medicaid