Provider Demographics
NPI:1780929877
Name:FRANK M. FUENTES M.D. & ASSOCIATES. P.A. INC.
Entity type:Organization
Organization Name:FRANK M. FUENTES M.D. & ASSOCIATES. P.A. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:M
Authorized Official - Last Name:FUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-673-5100
Mailing Address - Street 1:114 2ND SAN MARINO TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-1122
Mailing Address - Country:US
Mailing Address - Phone:305-673-5100
Mailing Address - Fax:305-673-9106
Practice Address - Street 1:114 2ND SAN MARINO TER
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-1122
Practice Address - Country:US
Practice Address - Phone:305-673-5100
Practice Address - Fax:305-673-9106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-30
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 42120207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty