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General NPI Number Information
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NPI Number | 1821089699
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Entity Type | Individual
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Provider Name | JEFFREY FRIEDMAN D.O.
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Gender | Male
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 937 N SPRING GARDEN AVE
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City | DELAND
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State | FL
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Zip | 32720-2560
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Country | US
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Telephone | 386-736-1948
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Fax | 386-736-2784
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Provider Business Mailing Address
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Address Line | 154 STANDISH DR
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City | ORMOND BEACH
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State | FL
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Zip | 32176-4751
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Country | US
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Telephone | 386-299-2546
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS0005813
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License Number State | FL
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