Provider Demographics
NPI:1689775918
Name:FRAZER, TROY D (DO)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:D
Last Name:FRAZER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3550 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 710
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3841
Mailing Address - Country:US
Mailing Address - Phone:305-438-0258
Mailing Address - Fax:305-438-0261
Practice Address - Street 1:3550 BISCAYNE BLVD
Practice Address - Street 2:SUITE 710
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3841
Practice Address - Country:US
Practice Address - Phone:305-438-0258
Practice Address - Fax:305-438-0261
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS8154207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261937700Medicaid
FLE6330ZMedicare PIN
FL261937700Medicaid