1417078437 NPI number — DR JULIE FREEDMAN DDS PA

Table of content: (NPI 1417078437)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417078437 NPI number — DR JULIE FREEDMAN DDS PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR JULIE FREEDMAN DDS PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417078437
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/10/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10978 PEMBROKE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIRAMAR
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33025-6540
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-438-3803
Provider Business Mailing Address Fax Number:
954-433-1885

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10978 PEMBROKE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIRAMAR
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33025-6540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-438-3803
Provider Business Practice Location Address Fax Number:
954-433-1885
Provider Enumeration Date:
04/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MIRABAL
Authorized Official First Name:
LOURDES
Authorized Official Middle Name:
Authorized Official Title or Position:
INSURANCE CONSULTANT
Authorized Official Telephone Number:
954-438-3803

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DN0014735 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1417078437 . This is a "DELTA DENTAL" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "SEMINOLE TRIBE FL HEALTH PLAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "GUARDIAN" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "DELTA DENTAL" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "DELTA DENTAL" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "DELTA DENTAL" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "DELTA DENTAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "DELTA DENTAL" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "DELTA DENTAL" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "BLUECROSS BLUESHIELD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "BLUECROSS BLUESHIELD" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "AMERITAS LIFE INSURANCE COMPANY" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "HUMANA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "AETNA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "DELTA DENTAL" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "DELTA DENTAL" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "CENTRAL STATES, SE&SW AREAS" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "PRINCIPLE FINANCIAL GROUP" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1417078437 . This is a "MERITAIN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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