Healthcare Provider Details

I. General information

NPI: 1023934692
Provider Name (Legal Business Name): FROES MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 NE 167TH ST UNIT 103
MIAMI FL
33162-3400
US

IV. Provider business mailing address

152 NE 167TH ST UNIT 103
MIAMI FL
33162-3400
US

V. Phone/Fax

Practice location:
  • Phone: 843-754-3443
  • Fax:
Mailing address:
  • Phone: 786-388-0860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHADLEY DECIO FROES
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 786-388-0860