Provider Demographics
NPI:1205030681
Name:COLPAS, FARIDES
Entity Type:Individual
Prefix:
First Name:FARIDES
Middle Name:
Last Name:COLPAS
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 1:916 NW 104TH AVE
Mailing Address - Street 2:APT 102
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3933
Mailing Address - Country:US
Mailing Address - Phone:305-926-6163
Mailing Address - Fax:
Practice Address - Street 1:327 W 9TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3853
Practice Address - Country:US
Practice Address - Phone:305-863-2233
Practice Address - Fax:305-863-3296
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist