# LAZARO FRAGA MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245413905
- **Authorized official:** RENE CASANOVA MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (305) 363-3675

## Contact information

- **Practice address:** 951 S LE JEUNE RD STE 302, CORAL GABLES, FL 33134-2616
- **Practice address phone:** (305) 443-5031
- **Mailing address:** 5590 W 20TH AVE STE 300, HIALEAH, FL 33016-7061
- **Mailing address phone:** (305) 442-1740
- **Mailing address fax:** (305) 442-2207

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | ACN961 | FL | — |
| 208000000X | Pediatrics Physician | 279233800 | FL | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/17/2007
- **Last updated:** 01/23/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 273617000 | — | FL |
| 05 | — | 279233800 | — | FL |