Provider Demographics
NPI:1912085242
Name:FRANK DEPENA MD PA
Entity Type:Organization
Organization Name:FRANK DEPENA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:DEPENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-227-9339
Mailing Address - Street 1:11760 SW 40TH ST
Mailing Address - Street 2:SUITE 701
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3582
Mailing Address - Country:US
Mailing Address - Phone:305-227-9339
Mailing Address - Fax:305-553-2842
Practice Address - Street 1:11760 SW 40TH ST
Practice Address - Street 2:SUITE 701
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3582
Practice Address - Country:US
Practice Address - Phone:305-227-9339
Practice Address - Fax:305-553-2842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7716Medicare ID - Type Unspecified