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General NPI Number Information
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NPI Number | 1467810895
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Entity Type | Individual
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Provider Name | ANDREA RAE FRAZIER M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/30/2016
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 800 PRUDENTIAL DR
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8211
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Country | US
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Telephone | 614-906-9653
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Fax |
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Provider Business Mailing Address
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Address Line | 13032 HUNTLEY MANOR DR
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City | JACKSONVILLE
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State | FL
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Zip | 32224-8420
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Country | US
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Telephone | 614-906-9653
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME133316
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License Number State | FL
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