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Individual

FREDERICK JAY FRICKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 273-7770
(352) 392-0547
Mailing address
8309 SW 39TH PL, GAINESVILLE, FL 32608-3640
(352) 273-7770
(352) 392-0547

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME74330
FL
2080P0202X
Pediatric Cardiology Physician
Primary
ME74330
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000748888A
GA
05
378890300
FL
Enumeration date
04/01/2006
Last updated
01/24/2017
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