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Individual
DR. JACINTO THOMAS FRAGOSO
Active
Individual
DR. JACINTO THOMAS FRAGOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AUD
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
1601000873
MI
231H00000X
Audiologist
Primary
23002773A
IN
231H00000X
Audiologist
A.02322
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
063220089
MEDICARE
IN
05
—
300071172
—
IN
Enumeration date
06/22/2020
Last updated
03/14/2023
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