Provider Demographics
NPI:1063604544
Name:FRAU, ADELFA M (MD)
Entity type:Individual
Prefix:MRS
First Name:ADELFA
Middle Name:M
Last Name:FRAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3850 SW 87TH AVENUE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165
Mailing Address - Country:US
Mailing Address - Phone:305-826-0002
Mailing Address - Fax:305-826-0411
Practice Address - Street 1:7100 WEST 20TH AVENUE
Practice Address - Street 2:SUITE 506
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016
Practice Address - Country:US
Practice Address - Phone:305-826-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0015878207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAFS844267OtherDEA
S3443Medicare PIN
D56519Medicare UPIN