Organization
MEDVANTAGE PLUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT L FRISKNEY (MGRM)
(800) 935-7303
Entity
Organization
Contact information
Practice address
951 BROKEN SOUND PKWY NW, STE 195, BOCA RATON, FL 33487-3507
(800) 935-7303
(561) 270-0239
Mailing address
951 BROKEN SOUND PKWY NW, STE 195, BOCA RATON, FL 33487-3507
(800) 935-7303
(561) 270-0239
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7512730001
MEDICARE PTAN
FL
Enumeration date
02/20/2013
Last updated
05/12/2017
Update your record
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