Healthcare Provider Details

I. General information

NPI: 1629307400
Provider Name (Legal Business Name): JACOB J. FREIMAN, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2009
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1213 E LAS OLAS BLVD
FORT LAUDERDALE FL
33301-2331
US

IV. Provider business mailing address

1213 E LAS OLAS BLVD
FORT LAUDERDALE FL
33301-2331
US

V. Phone/Fax

Practice location:
  • Phone: 516-987-5394
  • Fax:
Mailing address:
  • Phone: 516-987-5394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME102509
License Number StateFL

VIII. Authorized Official

Name: JACOB JOSHUA FREIMAN
Title or Position: OWNER
Credential:
Phone: 516-987-5394