Healthcare Provider Details

I. General information

NPI: 1477581726
Provider Name (Legal Business Name): LAWRENCE B FRIEDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 NW 12TH AVE MAILMAN CENTER, SUITE 1055
MIAMI FL
33136-1005
US

IV. Provider business mailing address

1601 NW 12TH AVE PO BOX 016820 (D-820)
MIAMI FL
33101-6820
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-5880
  • Fax: 305-243-5956
Mailing address:
  • Phone: 305-243-5880
  • Fax: 305-243-5956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME41232
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberME41232
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: