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General NPI Number Information
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NPI Number | 1962610642
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Entity Type | Individual
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Provider Name | JASON C FRIEDRICHS M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 6900 INTERNATIONAL CENTER BLVD
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City | FORT MYERS
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State | FL
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Zip | 33912-7151
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Country | US
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Telephone | 815-895-3937
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Fax | 815-991-9178
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Provider Business Mailing Address
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Address Line | 1806 PRINCESS CT
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City | NAPLES
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State | FL
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Zip | 34110-1002
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Country | US
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Telephone | 815-895-3937
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Fax | 815-991-9178
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | R-7682
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 036.120383
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License Number State | IL
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