MEDICARE: ALEJANDRO ERNESTO FRUTO CAPDET

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZC0007X	Surgical Assistant	24-341	FL

General Provider Information

NPI Number	:	1275377350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRO ERNESTO FRUTO CAPDET

Provider Business Mailing Address
First Line	:	6355 SW 8TH ST APT 611
Second Line	:
City	:	WEST MIAMI
State	:	FL
Zip	:	33144-4857
Country	:	US
Telephone Number	:	404-710-5354
Fax Number	:

Provider Business Practice Location Address
First Line	:	6355 SW 8TH ST APT 611
Second Line	:
City	:	WEST MIAMI
State	:	FL
Zip	:	33144-4857
Country	:	US
Telephone Number	:	404-710-5354
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2024
Last Update Date	:	06/24/2024

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