Provider Demographics
NPI:1891856233
Name:FRADE, MANUEL HIPOLITO (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:HIPOLITO
Last Name:FRADE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8080 W FLAGLER ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2100
Mailing Address - Country:US
Mailing Address - Phone:305-262-8280
Mailing Address - Fax:305-262-8227
Practice Address - Street 1:8080 W FLAGLER ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2100
Practice Address - Country:US
Practice Address - Phone:305-262-8280
Practice Address - Fax:305-262-8227
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLFLMEO043366207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL96380OtherOTHER PAYORS
FL96380OtherOTHER PAYORS