Individual
SANTIAGO FRAGOSO SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5453 CHANDLER DR, WINTER HAVEN, FL 33884-4155
(606) 585-8523
Mailing address
5453 CHANDLER DR, WINTER HAVEN, FL 33884-4155
(606) 585-8523
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
419539
—
Other
Enumeration date
08/05/2018
Last updated
08/05/2018
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