Provider Demographics
NPI:1841638475
Name:FANTO, FRANK
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:FANTO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 VISTA PARKWAY
Mailing Address - Street 2:SUITE 4034
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411
Mailing Address - Country:US
Mailing Address - Phone:561-275-9051
Mailing Address - Fax:561-828-5954
Practice Address - Street 1:2101 VISTA PARKWAY
Practice Address - Street 2:SUITE 4034
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411
Practice Address - Country:US
Practice Address - Phone:561-228-6134
Practice Address - Fax:561-828-5954
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies