Healthcare Provider Details

I. General information

NPI: 1730192915
Provider Name (Legal Business Name): JARROD D FRIEDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 11/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5458 TOWN CENTER RD SUITE 103
BOCA RATON FL
33486-1089
US

IV. Provider business mailing address

5458 TOWN CENTER RD SUITE 103
BOCA RATON FL
33486-1089
US

V. Phone/Fax

Practice location:
  • Phone: 561-923-9599
  • Fax:
Mailing address:
  • Phone: 561-923-9599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number01059597A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberD65804
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME107418
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberME107418
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberME107418
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberME107418
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: