Individual
JOSE M. FRAGOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1210 S OLD DIXIE HWY, JUPITER, FL 33458-7205
(561) 748-1523
Mailing address
800 SPRUCE ST, PHILADELPHIA, PA 19107-6130
(215) 829-5933
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME113442
FL
2085R0202X
Diagnostic Radiology Physician
MT190604
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023154600
—
FL
Enumeration date
08/23/2007
Last updated
04/22/2020
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