MEDICARE: MICHELLE FRIEDMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1104122068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE FRIEDMAN

Provider Business Mailing Address
First Line	:	7901 4TH ST N STE 8163
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33702-4305
Country	:	US
Telephone Number	:	631-219-7436
Fax Number	:

Provider Business Practice Location Address
First Line	:	7901 4TH ST N STE 8163
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33702-4305
Country	:	US
Telephone Number	:	631-219-7436
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2011
Last Update Date	:	10/29/2021

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Directions to “ MICHELLE FRIEDMAN ” Practice Location

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