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General NPI Number Information
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NPI Number | 1265424881
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Entity Type | Individual
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Provider Name | ENRIQUE Z FRAGA MD
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Gender | Male
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Dates
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Enumeration Date | 08/19/2005
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 2300 WEST 84 ST SUITE 501
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City | MIAMI
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State | FL
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Zip | 33016-1029
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Country | US
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Telephone | 305-273-5511
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Fax | 305-273-6622
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Provider Business Mailing Address
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Address Line | 2300 W 84TH ST 501
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City | HIALEAH
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State | FL
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Zip | 33016-5770
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Country | US
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Telephone | 305-273-5511
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Fax | 305-273-5511
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 0046427
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License Number State | FL
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