MEDICARE: MR. FEDERICO A FRIAS M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	ME87970	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407872849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FEDERICO A FRIAS M.D

Provider Business Mailing Address
First Line	:	5255 OFFICE PARK BLVD
Second Line	:	SUITE 110
City	:	BRADENTON
State	:	FL
Zip	:	34203-3443
Country	:	US
Telephone Number	:	941-755-7000
Fax Number	:	941-755-7088

Provider Business Practice Location Address
First Line	:	5255 OFFICE PARK BLVD
Second Line	:	SUITE 110
City	:	BRADENTON
State	:	FL
Zip	:	34203-3443
Country	:	US
Telephone Number	:	941-755-7000
Fax Number	:	941-755-7088

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	04/25/2014

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