Healthcare Provider Details

I. General information

NPI: 1699420067
Provider Name (Legal Business Name): BART AL FRIEDMAN RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2022
Last Update Date: 02/15/2022
Certification Date: 02/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8140 NW 48TH LN
OCALA FL
34482-2002
US

IV. Provider business mailing address

8140 NW 48TH LN
OCALA FL
34482-2002
US

V. Phone/Fax

Practice location:
  • Phone: 352-789-2914
  • Fax:
Mailing address:
  • Phone: 352-789-2914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License NumberRT802
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: