Healthcare Provider Details

I. General information

NPI: 1639852361
Provider Name (Legal Business Name): PSYCHIATRIC ASSOCIATES OF FLORIDA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 FIFTH AVE S STE 200
NAPLES FL
34102-6632
US

IV. Provider business mailing address

780 FIFTH AVE S STE 200
NAPLES FL
34102-6632
US

V. Phone/Fax

Practice location:
  • Phone: 239-359-4393
  • Fax: 201-568-8105
Mailing address:
  • Phone: 239-359-4393
  • Fax: 201-568-8105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAY LAWRENCE FRIEDMAN
Title or Position: OWNER / MANAGING MEMBER
Credential: MD
Phone: 201-314-7648