MEDICARE: RAFAEL A FRIAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	173C00000X	Reflexologist	39166	FL

General Provider Information

NPI Number	:	1659529576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAFAEL A FRIAS

Provider Business Mailing Address
First Line	:	2123 MARTIN LUTHER KING BOULEVARD
Second Line	:	SUITE 202
City	:	TAMPA
State	:	FL
Zip	:	33607
Country	:	US
Telephone Number	:	813-873-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2123 MARTIN LUTHER KING BOULEVARD
Second Line	:	SUITE 202
City	:	TAMPA
State	:	FL
Zip	:	33607
Country	:	US
Telephone Number	:	813-873-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2008
Last Update Date	:	09/04/2008

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Directions to “ RAFAEL A FRIAS ” Practice Location

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