Provider Demographics
NPI:1912534587
Name:FROES, CHADLEY DECIO (MD)
Entity type:Individual
Prefix:DR
First Name:CHADLEY
Middle Name:DECIO
Last Name:FROES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 NW 170TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5576
Mailing Address - Country:US
Mailing Address - Phone:305-651-1100
Mailing Address - Fax:
Practice Address - Street 1:160 NW 170TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-5576
Practice Address - Country:US
Practice Address - Phone:305-651-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0098110207R00000X
390200000X
FL173908207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program