1326390782 NPI number — MR. JEFFREY MICHAEL FRIEDMAN LCSW

Table of content: MR. JEFFREY MICHAEL FRIEDMAN LCSW (NPI 1326390782)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326390782 NPI number — MR. JEFFREY MICHAEL FRIEDMAN LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRIEDMAN
Provider First Name:
JEFFREY
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
M

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:
1326390782
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/06/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1800 S OCEAN DR
Provider Second Line Business Mailing Address:
APT 1904
Provider Business Mailing Address City Name:
HALLANDALE BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33009-7734
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-494-9914
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20801 BISCAYNE BLVD
Provider Second Line Business Practice Location Address:
SUITE 4003
Provider Business Practice Location Address City Name:
AVENTURA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33180-1430
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-932-0016
Provider Business Practice Location Address Fax Number:
305-932-1262
Provider Enumeration Date:
10/10/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  SW11058 , 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)





Copyright © 2007-2025 www.npivalidator.com