Healthcare Provider Details

I. General information

NPI: 1417880097
Provider Name (Legal Business Name): KRISTINE D FREIRE SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7340 SW 48TH ST STE 106
MIAMI FL
33155-5520
US

IV. Provider business mailing address

12762 SW 146TH LN
MIAMI FL
33186-6355
US

V. Phone/Fax

Practice location:
  • Phone: 305-501-1513
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI8776
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: