Provider Demographics
NPI:1871553826
Name:VICINI, FRANK A (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:A
Last Name:VICINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:70 FULTON ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-2755
Practice Address - Country:US
Practice Address - Phone:248-338-0300
Practice Address - Fax:248-338-0663
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43014059832085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5178048OtherAETNA
MI01044814OtherHEALTH PLUS OF MICHIGAN THRU OAKLAND PHYSICIANS NETWORK SERVICES (OPNS)
MI103393OtherUNITED HEALTHCARE COMMUNITY PLAN
MI2667173Medicaid
MI320F362430OtherBCBSM
MIP01013939OtherRAILROAD MEDICARE
MI41723OtherHEALTH PLAN OF MICHIGAN
MI5178048OtherAETNA THRU OAKLAND PHYSICIANS NETWORK SERVICES
MI01044814OtherHEALTH PLUS OF MICHIGAN THRU OAKLAND PHYSICIANS NETWORK SERVICES (OPNS)
MI5178048OtherAETNA THRU OAKLAND PHYSICIANS NETWORK SERVICES
MIF36434021Medicare PIN