Provider Demographics
NPI:1871339895
Name:PHILIPPE, FRANTZLEY
Entity type:Individual
Prefix:
First Name:FRANTZLEY
Middle Name:
Last Name:PHILIPPE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:FRANTZLEY
Other - Middle Name:
Other - Last Name:PHILIPPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:3101 SW 23RD CT
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-4327
Mailing Address - Country:US
Mailing Address - Phone:561-377-9002
Mailing Address - Fax:
Practice Address - Street 1:5420 NW 33RD AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-6348
Practice Address - Country:US
Practice Address - Phone:754-800-9326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-357-823106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician