Provider Demographics
NPI:1114489762
Name:FRAUENFELD, LINA M (MD)
Entity type:Individual
Prefix:
First Name:LINA
Middle Name:M
Last Name:FRAUENFELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 MANATEE AVE W # AW
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-1711
Mailing Address - Country:US
Mailing Address - Phone:941-746-5840
Mailing Address - Fax:
Practice Address - Street 1:3701 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-1711
Practice Address - Country:US
Practice Address - Phone:941-746-5840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME160921207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology