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General NPI Number Information
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NPI Number | 1972278109
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Entity Type | Organization
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Legal Business Name | CORESMART, INC.
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Dates
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Enumeration Date | 08/10/2021
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 5458 TOWN CENTER RD STE 103
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City | BOCA RATON
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State | FL
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Zip | 33486-1026
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Country | US
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Telephone | 561-923-9599
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Fax | 561-923-9602
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Provider Business Mailing Address
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Address Line | 5458 TOWN CENTER RD STE 103
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City | BOCA RATON
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State | FL
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Zip | 33486-1026
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Country | US
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Telephone | 561-923-9599
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Fax | 561-923-9602
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Authorized Official
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Title or Position | PRESIDENT
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Name | JARROD D FRIEDMAN
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Credential | MD
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Telephone | 561-923-9599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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