Basic Information
| Provider Information | |||||||||
| NPI: | 1265537435 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FRAGA PEDIATRICS & ASSOCIATES OF KENDALL, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 351597 | ||||||||
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| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331357597 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054435063 | ||||||||
| FaxNumber: | 3054431336 | ||||||||
| Practice Location | |||||||||
| Address1: | 8900 SW 117TH AVE | ||||||||
| Address2: | SUITE B-208 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331862175 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055953334 | ||||||||
| FaxNumber: | 3052715362 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HUERTAS | ||||||||
| AuthorizedOfficialFirstName: | NORKI | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3054435063 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.