Healthcare Provider Details

I. General information

NPI: 1265537435
Provider Name (Legal Business Name): FRAGA PEDIATRICS & ASSOCIATES OF KENDALL, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 SW 117TH AVE SUITE B-208
MIAMI FL
33186-2175
US

IV. Provider business mailing address

PO BOX 351597
MIAMI FL
33135-7597
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-3334
  • Fax: 305-271-5362
Mailing address:
  • Phone: 305-443-5063
  • Fax: 305-443-1336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: NORKI HUERTAS
Title or Position: PRESIDENT
Credential:
Phone: 305-443-5063