MEDICARE: MS. LISA FRIEDMAN MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW5369	FL

General Provider Information

NPI Number	:	1497834154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LISA FRIEDMAN MSW, LCSW

Provider Business Mailing Address
First Line	:	9715 W. BROWARD BLVD.
Second Line	:	P.M. BOX 148
City	:	PLANTATION
State	:	FL
Zip	:	33324-2351
Country	:	US
Telephone Number	:	954-741-1099
Fax Number	:	954-585-0177

Provider Business Practice Location Address
First Line	:	7376 NW 5TH ST
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33317-1605
Country	:	US
Telephone Number	:	954-741-1099
Fax Number	:	954-585-0177

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	05/25/2010

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