Provider Demographics
NPI:1962599787
Name:CHERY, FRANTZ (MD)
Entity type:Individual
Prefix:
First Name:FRANTZ
Middle Name:
Last Name:CHERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 W OAKLAND PARK BLVD
Mailing Address - Street 2:#201
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33313-1501
Mailing Address - Country:US
Mailing Address - Phone:954-533-8294
Mailing Address - Fax:954-616-8394
Practice Address - Street 1:4900 W OAKLAND PARK BLVD
Practice Address - Street 2:#201
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-1501
Practice Address - Country:US
Practice Address - Phone:954-533-8294
Practice Address - Fax:954-616-8394
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0050652208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL061782200Medicaid
FL061782200Medicaid
FL9305XMedicare PIN