Provider Demographics
NPI:1144843475
Name:DESAMOUR, FRANTZ
Entity type:Individual
Prefix:
First Name:FRANTZ
Middle Name:
Last Name:DESAMOUR
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 1:323 IVES DAIRY RD APT 2
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3348
Mailing Address - Country:US
Mailing Address - Phone:786-344-1034
Mailing Address - Fax:
Practice Address - Street 1:111 NW 183RD ST STE 202
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4578
Practice Address - Country:US
Practice Address - Phone:786-344-1034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty