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NPI Code Detail

MEDICARE: DR. ANDREA RAE FRAZIER M.D.

MEDICARE: DR. ANDREA RAE FRAZIER M.D.
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
1208000000XPediatrics PhysicianME133316FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467810895
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREA RAE FRAZIER M.D.
Provider Business Mailing Address
First Line : 13032 HUNTLEY MANOR DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32224-8420
Country : US
Telephone Number : 614-906-9653
Fax Number :
Provider Business Practice Location Address
First Line : 800 PRUDENTIAL DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8211
Country : US
Telephone Number : 614-906-9653
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2016
Last Update Date : 05/07/2025

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