Healthcare Provider Details

I. General information

NPI: 1255866364
Provider Name (Legal Business Name): JUAN DANIEL DEL CID FRATTI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2017
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3704 BIENVILLE BLVD STE B
OCEAN SPRINGS MS
39564-5710
US

IV. Provider business mailing address

3704 BIENVILLE BLVD STE B
OCEAN SPRINGS MS
39564-5710
US

V. Phone/Fax

Practice location:
  • Phone: 228-872-4040
  • Fax: 312-864-9725
Mailing address:
  • Phone: 228-872-4040
  • Fax: 312-864-9725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number35301
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: