Healthcare Provider Details

I. General information

NPI: 1659465375
Provider Name (Legal Business Name): ROBERT JAY FRIEDMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 02/02/2020
Certification Date: 02/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 PGA BLVD STE 200
PALM BEACH GARDENS FL
33418-3836
US

IV. Provider business mailing address

5600 PGA BLVD STE 200
PALM BEACH GARDENS FL
33418-3836
US

V. Phone/Fax

Practice location:
  • Phone: 561-842-7246
  • Fax: 561-408-0950
Mailing address:
  • Phone: 561-842-7246
  • Fax: 561-408-0950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License NumberME 69852
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME 69852
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: