Basic Information
| Provider Information | |||||||||
| NPI: | 1235719360 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CUSIMANO | ||||||||
| FirstName: | FRANK | ||||||||
| MiddleName: | ANTHONY | ||||||||
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| Credential: | DO, PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4414 KELLY DR | ||||||||
| Address2: | |||||||||
| City: | RICHARDSON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750822653 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2145388052 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1611 NW 12TH AVE | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331361005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055851111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2021 | ||||||||
| LastUpdateDate: | 04/13/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 22830452 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.