Healthcare Provider Details

I. General information

NPI: 1992265789
Provider Name (Legal Business Name): THOMAS FRAUENHOFER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4012 KELCEY CT STE 202
TALLAHASSEE FL
32308-5986
US

IV. Provider business mailing address

4012 KELCEY CT STE 202
TALLAHASSEE FL
32308-5986
US

V. Phone/Fax

Practice location:
  • Phone: 850-559-2355
  • Fax: 800-443-1468
Mailing address:
  • Phone: 850-559-2355
  • Fax: 800-443-1468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberOS18631
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS18631
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: