Provider Demographics
NPI:1275377350
Name:FRUTO CAPDET, ALEJANDRO ERNESTO
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:ERNESTO
Last Name:FRUTO CAPDET
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6355 SW 8TH ST APT 611
Mailing Address - Street 2:
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4857
Mailing Address - Country:US
Mailing Address - Phone:404-710-5354
Mailing Address - Fax:
Practice Address - Street 1:6355 SW 8TH ST APT 611
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4857
Practice Address - Country:US
Practice Address - Phone:404-710-5354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24-341246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant