Provider Demographics
NPI:1073346029
Name:DEVITO, FRANK
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:DEVITO
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 1:9333 N CHURCH DR APT 405
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-4718
Mailing Address - Country:US
Mailing Address - Phone:440-554-7706
Mailing Address - Fax:
Practice Address - Street 1:9333 N CHURCH DR APT 405
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-4718
Practice Address - Country:US
Practice Address - Phone:440-554-7706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-24
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN498709172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver