Provider Demographics
NPI:1447527478
Name:FRANKLIN, SAMUEL DWIGHT (AP)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:DWIGHT
Last Name:FRANKLIN
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 LAKE CENTER DR
Mailing Address - Street 2:APT 26105
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-6532
Mailing Address - Country:US
Mailing Address - Phone:270-339-3299
Mailing Address - Fax:
Practice Address - Street 1:3530 LAKE CENTER DR
Practice Address - Street 2:APT 26105
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-6532
Practice Address - Country:US
Practice Address - Phone:270-339-3299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-18
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3007171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist