Healthcare Provider Details

I. General information

NPI: 1154249969
Provider Name (Legal Business Name): FRET MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2213 PONCE BYP
PONCE PR
00717-1310
US

IV. Provider business mailing address

PO BOX 3583
VEGA ALTA PR
00692-3583
US

V. Phone/Fax

Practice location:
  • Phone: 832-654-6573
  • Fax:
Mailing address:
  • Phone: 832-654-6573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEXANDER FRET CRUZ
Title or Position: OWNER
Credential: MD
Phone: 832-654-6573