Provider Demographics
NPI:1083201826
Name:AU DE FRAIOLI, KARINA E
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:E
Last Name:AU DE FRAIOLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 NW 78TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1816
Mailing Address - Country:US
Mailing Address - Phone:786-618-5174
Mailing Address - Fax:786-703-3987
Practice Address - Street 1:1200 NW 78TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1816
Practice Address - Country:US
Practice Address - Phone:786-618-5174
Practice Address - Fax:786-703-3987
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator