MEDICARE: DR. MARK A FREHER MD

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	207RC0001X	Clinical Cardiac Electrophysiology Physician	ME83227	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	060065771	OTHER	FL	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	591975559	OTHER	FL	TAX ID
2	03207	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578576856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK A FREHER MD

Provider Business Mailing Address
First Line	:	1841 NE 45TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5117
Country	:	US
Telephone Number	:	954-678-9531
Fax Number	:	954-678-9533

Provider Business Practice Location Address
First Line	:	5258 LINTON BLVD STE 106
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-6529
Country	:	US
Telephone Number	:	561-303-3491
Fax Number	:	877-248-5240

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

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	12/17/2019

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Directions to “ DR. MARK A FREHER MD” Practice Location

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