Basic Information
| Provider Information | |||||||||
| NPI: | 1932204179 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LAZARO FRAGA, M.D., P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 351597 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331357597 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054435063 | ||||||||
| FaxNumber: | 3054431336 | ||||||||
| Practice Location | |||||||||
| Address1: | 4141 SW 6TH ST | ||||||||
| Address2: | |||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331342057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054435031 | ||||||||
| FaxNumber: | 3054420844 | ||||||||
| 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 | 2080A0000X | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine | 208D00000X | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.