Healthcare Provider Details

I. General information

NPI: 1053240580
Provider Name (Legal Business Name): ROSANA FRIAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 NW 79TH AVE STE 230
DORAL FL
33166-6554
US

IV. Provider business mailing address

3901 NW 79TH AVE STE 230
DORAL FL
33166-6554
US

V. Phone/Fax

Practice location:
  • Phone: 305-322-3371
  • Fax:
Mailing address:
  • Phone: 305-322-3371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROSANA FRIAS
Title or Position: CEO
Credential:
Phone: 305-322-3371