Provider Demographics
NPI:1164628566
Name:FRANCIS, RUPERT A
Entity type:Individual
Prefix:DR
First Name:RUPERT
Middle Name:A
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:RUPERT
Other - Middle Name:A
Other - Last Name:FRANCIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:15047 SW 36TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33331-2733
Mailing Address - Country:US
Mailing Address - Phone:954-966-7911
Mailing Address - Fax:954-966-3352
Practice Address - Street 1:625 S STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33023-6723
Practice Address - Country:US
Practice Address - Phone:954-966-7911
Practice Address - Fax:954-966-3352
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81149174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist