Healthcare Provider Details

I. General information

NPI: 1609949957
Provider Name (Legal Business Name): FRIEDMAN & GREENHUT DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 12/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

542067 US HIGHWAY 1
CALLAHAN FL
32011-8110
US

IV. Provider business mailing address

542067 US HIGHWAY 1 P.O. BOX 1578
CALLAHAN FL
32011-8110
US

V. Phone/Fax

Practice location:
  • Phone: 904-879-2552
  • Fax: 904-879-6360
Mailing address:
  • Phone: 904-879-2552
  • Fax: 904-879-6360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: MARY EUNICE ROWELL
Title or Position: OFFICE MANAGER
Credential:
Phone: 904-879-2552