Provider Demographics
NPI:1972483204
Name:FREYTES, MARISOL CRISTINA
Entity type:Individual
Prefix:MS
First Name:MARISOL
Middle Name:CRISTINA
Last Name:FREYTES
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 1:1600 SW 78TH AVE APT N-316
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3392
Mailing Address - Country:US
Mailing Address - Phone:407-492-9152
Mailing Address - Fax:
Practice Address - Street 1:15485 EAGLE NEST LN STE 220
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2222
Practice Address - Country:US
Practice Address - Phone:786-477-5783
Practice Address - Fax:305-512-8805
Is Sole Proprietor?:No
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ12951235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist