Provider Demographics
NPI:1265537435
Name:FRAGA PEDIATRICS & ASSOCIATES OF KENDALL, P.A.
Entity type:Organization
Organization Name:FRAGA PEDIATRICS & ASSOCIATES OF KENDALL, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NORKI
Authorized Official - Middle Name:
Authorized Official - Last Name:HUERTAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-443-5063
Mailing Address - Street 1:PO BOX 351597
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-7597
Mailing Address - Country:US
Mailing Address - Phone:305-443-5063
Mailing Address - Fax:305-443-1336
Practice Address - Street 1:8900 SW 117TH AVE
Practice Address - Street 2:SUITE B-208
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-2175
Practice Address - Country:US
Practice Address - Phone:305-595-3334
Practice Address - Fax:305-271-5362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty