Basic Information
| Provider Information | |||||||||
| NPI: | 1750770806 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRIAS | ||||||||
| FirstName: | AMAURY | ||||||||
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| Credential: | SURGICAL ASSISTANT C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2645 SW 37 AVE | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054613229 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2645 SW 37TH AVE | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331332754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054613229 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2015 | ||||||||
| LastUpdateDate: | 01/13/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246ZC0007X | 14-344 | CA | Y | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Certified First Assistant |
No ID Information.