Healthcare Provider Details

I. General information

NPI: 1225442742
Provider Name (Legal Business Name): MARIA FRIED RT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2014
Last Update Date: 06/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16967 SW 113TH CT
MIAMI FL
33157-3916
US

IV. Provider business mailing address

16967 SW 113TH CT
MIAMI FL
33157-3916
US

V. Phone/Fax

Practice location:
  • Phone: 305-498-4454
  • Fax:
Mailing address:
  • Phone: 305-498-4454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License NumberRT9942
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: