Provider Demographics
NPI:1104100346
Name:ERVOLINO, FRANK S
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:S
Last Name:ERVOLINO
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 1:4820 SW LAKE GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-8503
Mailing Address - Country:US
Mailing Address - Phone:772-341-0326
Mailing Address - Fax:
Practice Address - Street 1:1320 S FEDERAL HWY STE 203
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3409
Practice Address - Country:US
Practice Address - Phone:772-341-0326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1330208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation