Healthcare Provider Details

I. General information

NPI: 1649284043
Provider Name (Legal Business Name): HAROLD FROLICH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 05/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 SW 34TH AVE SUITE 116
OCALA FL
34474-7448
US

IV. Provider business mailing address

24050 COMMERCE PARK SUITE 100
BEACHWOOD OH
44122-5833
US

V. Phone/Fax

Practice location:
  • Phone: 352-789-6616
  • Fax: 352-789-6582
Mailing address:
  • Phone: 216-896-9301
  • Fax: 216-896-9302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number35062996
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME109489
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: