MEDICARE: SCOTT FRIEDBERG DO PA

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	207Q00000X	Family Medicine Physician	OS 8518	FL

General Provider Information

NPI Number	:	1699927483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT FRIEDBERG DO PA

Provider Business Mailing Address
First Line	:	6611 W BOYNTON BEACH BLVD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3526
Country	:	US
Telephone Number	:	954-801-8144
Fax Number	:	561-338-8435

Provider Business Practice Location Address
First Line	:	6611 W BOYNTON BEACH BLVD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3526
Country	:	US
Telephone Number	:	954-801-8144
Fax Number	:	561-338-8435

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SCOTT L FRIEDBERG
Credential	:	D.O.
Telephone Number	:	954-801-8144

Provider Enumeration Date	:	10/13/2008
Last Update Date	:	10/13/2008

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