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General NPI Number Information
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NPI Number | 1801069026
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Entity Type | Organization
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Legal Business Name | DR CHARLES A FRARACCIO
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 2150 SE SALERNO RD SUITE 110
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City | STUART
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State | FL
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Zip | 34997
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Country | US
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Telephone | 772-286-4100
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Fax | 772-223-5749
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Provider Business Mailing Address
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Address Line | 2150 SE SALERNO RD SUITE 110
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City | STUART
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State | FL
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Zip | 34997
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Country | US
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Telephone | 772-286-4100
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Fax | 772-223-5749
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Authorized Official
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Title or Position | ORTHOPAEDIC SURGEON
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Name | CHARLES A FRARACCIO
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Credential | MD
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Telephone | 772-286-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME32708
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License Number State | FL
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