Provider Demographics
NPI:1164568481
Name:FRADE-EGUARAS, SILVIA (ITDS)
Entity Type:Individual
Prefix:MRS
First Name:SILVIA
Middle Name:
Last Name:FRADE-EGUARAS
Suffix:
Gender:F
Credentials:ITDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF MIAMI - EARLY STEPS PROGRAM
Mailing Address - Street 2:1601 NW 12 AVE
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1005
Mailing Address - Country:US
Mailing Address - Phone:305-243-6660
Mailing Address - Fax:305-243-3501
Practice Address - Street 1:UNIVERSITY OF MIAMI - EARLY STEPS PROGRAM
Practice Address - Street 2:1601 NW 12 AVE
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-243-6660
Practice Address - Fax:305-243-3501
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL811229100Medicaid
FL768153400Medicaid