Provider Demographics
NPI:1972615060
Name:FRONSTIN, FRED E (DC)
Entity type:Individual
Prefix:
First Name:FRED
Middle Name:E
Last Name:FRONSTIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1383 W PALMETTO PARK RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-3314
Mailing Address - Country:US
Mailing Address - Phone:561-338-9200
Mailing Address - Fax:561-338-3651
Practice Address - Street 1:1383 W PALMETTO PARK RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-3314
Practice Address - Country:US
Practice Address - Phone:561-338-9200
Practice Address - Fax:561-338-3651
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0002020111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89599OtherBLUE CROSS BLUE SHIELD