MEDICARE: FRIEDMAN PROSTHODONTICS, P.A.

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	1223P0700X	Prosthodontics	DN16718	FL

General Provider Information

NPI Number	:	1760654065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIEDMAN PROSTHODONTICS, P.A.

Provider Business Mailing Address
First Line	:	9825 W SAMPLE RD STE 100
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4040
Country	:	US
Telephone Number	:	954-752-5560
Fax Number	:	954-752-5561

Provider Business Practice Location Address
First Line	:	9825 W SAMPLE RD STE 100
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4040
Country	:	US
Telephone Number	:	954-752-5560
Fax Number	:	954-752-5561

Authorized Official
Title or Position	:	PROSTHODONTIST
Name	:	ELI M. FRIEDMAN
Credential	:	D.M.D.
Telephone Number	:	954-752-5560

Provider Enumeration Date	:	03/26/2008
Last Update Date	:	03/26/2008

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