Provider Demographics
NPI:1144245101
Name:FRANCO, EDSON SALVADOR (MD)
Entity type:Individual
Prefix:DR
First Name:EDSON
Middle Name:SALVADOR
Last Name:FRANCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EDSON
Other - Middle Name:S
Other - Last Name:FRANCO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-831-2763
Mailing Address - Fax:954-712-3970
Practice Address - Street 1:1625 SE 3RD AVE STE 721
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2521
Practice Address - Country:US
Practice Address - Phone:954-831-2763
Practice Address - Fax:954-712-3970
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00103378208600000X
FLME103378204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000944200Medicaid
FLBP754ZMedicare PIN
H99047Medicare UPIN