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General NPI Number Information
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NPI Number | 1235058397
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Entity Type | Individual
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Provider Name | EDUARDO RAUDEL FRAGA MENDEZ APRN
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Gender | Male
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 4847 DAVID S MACK DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-8023
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Country | US
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Telephone | 561-868-2993
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Fax |
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Provider Business Mailing Address
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Address Line | 1835 LAKESHORE AVE LOT 13
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-5118
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Country | US
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Telephone | 561-601-8849
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11049138
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License Number State | FL
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