Provider Demographics
NPI:1073020855
Name:SIMPLICE, FRANDDY (LDO)
Entity type:Individual
Prefix:MR
First Name:FRANDDY
Middle Name:
Last Name:SIMPLICE
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 NW 120TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33167-2847
Mailing Address - Country:US
Mailing Address - Phone:305-502-1326
Mailing Address - Fax:
Practice Address - Street 1:1525 NW 120TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33167-2847
Practice Address - Country:US
Practice Address - Phone:305-502-1326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO6774156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician