Healthcare Provider Details

I. General information

NPI: 1780157321
Provider Name (Legal Business Name): RICHARD FREIJ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2019
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9770 S MILITARY TRL # B4-255
BOYNTON BEACH FL
33436-3207
US

IV. Provider business mailing address

9770 S MILITARY TRL # B4-255
BOYNTON BEACH FL
33436-3207
US

V. Phone/Fax

Practice location:
  • Phone: 412-330-7133
  • Fax:
Mailing address:
  • Phone: 561-203-0707
  • Fax: 561-526-8471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME138643
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: