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General NPI Number Information
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NPI Number | 1306097357
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Entity Type | Organization
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Legal Business Name | CJL ANESTHESIA LLC
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Dates
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Enumeration Date | 10/08/2008
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Last Update Date | 10/08/2008
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Provider Practice Location Address
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Address Line | 8839 BRYAN DAIRY RD SUITE 215
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City | LARGO
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State | FL
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Zip | 33777-1203
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Country | US
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Telephone | 727-287-0650
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Fax | 727-287-0660
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Provider Business Mailing Address
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Address Line | PO BOX 7048
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City | SEMINOLE
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State | FL
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Zip | 33775-7048
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Country | US
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Telephone | 727-287-0650
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Fax | 727-287-0660
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CHARLES FRIEDMAN
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Credential | D.O.
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Telephone | 727-287-0650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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