Healthcare Provider Details
I. General information
NPI: 1780749481
Provider Name (Legal Business Name): STUART ANDREW FRIEDMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/25/2006
Last Update Date: 04/12/2020
Certification Date: 04/12/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5162 LINTON BLVD SUITE 201
DELRAY BEACH FL
33484-6567
US
IV. Provider business mailing address
5162 LINTON BLVD SUITE 201
DELRAY BEACH FL
33484-6567
US
V. Phone/Fax
- Phone: 561-495-2580
- Fax: 561-495-0928
- Phone: 561-495-2580
- Fax: 561-495-0928
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207KA0200X |
| Taxonomy | Allergy Physician |
| License Number | ME38998 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: