Provider Demographics
NPI:1144970567
Name:PANIAGUA, FRANKLIN ANTHONY JR (LMT)
Entity type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:ANTHONY
Last Name:PANIAGUA
Suffix:JR
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2541 ARAGON BLVD APT 107
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-3101
Mailing Address - Country:US
Mailing Address - Phone:954-839-7993
Mailing Address - Fax:
Practice Address - Street 1:4925 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-2834
Practice Address - Country:US
Practice Address - Phone:954-438-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA79318225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty