Healthcare Provider Details

I. General information

NPI: 1215176896
Provider Name (Legal Business Name): JEFFREY FRIEDLANDER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2009
Last Update Date: 02/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 W HILLSBOROUGH AVE
TAMPA FL
33615-3008
US

IV. Provider business mailing address

8451 SHADE AVE STE 108
SARASOTA FL
34243-2878
US

V. Phone/Fax

Practice location:
  • Phone: 813-886-9109
  • Fax: 813-886-9691
Mailing address:
  • Phone: 941-360-1030
  • Fax: 941-360-1202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME43369
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License NumberME43369
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License NumberME43369
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME43369
License Number StateFL

VIII. Authorized Official

Name: JEFFREY FRIEDLANDER
Title or Position: DIRECTOR
Credential: MD
Phone: 813-886-9109