Healthcare Provider Details
I. General information
NPI: 1831487255
Provider Name (Legal Business Name): FRYE MEDICAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/19/2011
Last Update Date: 07/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 HERITAGE DR STE 455
JUPITER FL
33458-2777
US
IV. Provider business mailing address
61 PINEHILL TRL W
TEQUESTA FL
33469-2158
US
V. Phone/Fax
- Phone: 561-601-9393
- Fax: 561-746-1522
- Phone: 561-601-9393
- Fax: 561-746-1522
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | ME0070655 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
DARRIN
LYLE
FRYE
Title or Position: PRESIDENT
Credential: MD
Phone: 561-601-9393