Provider Demographics
NPI:1124096474
Name:GENUARDI, FRANK JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOSEPH
Last Name:GENUARDI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 44008
Mailing Address - Street 2:UFJP PROVIDER ENROLLMENT
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4008
Mailing Address - Country:US
Mailing Address - Phone:904-244-3660
Mailing Address - Fax:904-244-3425
Practice Address - Street 1:655 W 8TH ST
Practice Address - Street 2:UFJP PEDIATRICS
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6511
Practice Address - Country:US
Practice Address - Phone:904-244-7260
Practice Address - Fax:904-244-3028
Is Sole Proprietor?:No
Enumeration Date:2006-03-12
Last Update Date:2007-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME68043208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCF26016Medicare UPIN
FL25612YMedicare PIN