Provider Demographics
NPI:1417978503
Name:DIENST, FRANK THEODORE III (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:THEODORE
Last Name:DIENST
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:805 CENTURY MEDICAL DR
Mailing Address - Street 2:CREDENTIALING OFFICE
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-2100
Mailing Address - Country:US
Mailing Address - Phone:321-268-6111
Mailing Address - Fax:321-268-6360
Practice Address - Street 1:951 N WASHINGTON AVE
Practice Address - Street 2:CRITICAL CARE DEPT
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2163
Practice Address - Country:US
Practice Address - Phone:321-268-6111
Practice Address - Fax:321-268-6360
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2016-02-18
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Provider Licenses
StateLicense IDTaxonomies
FLME43602207R00000X, 207RP1001X, 207RC0200X, 208M00000X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL069504100Medicaid
FL05501XMedicare PIN