MEDICARE: DR. ANDREA LYNN FRIEDMAN PH.D.

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	103G00000X	Clinical Neuropsychologist	PY6274	FL
2	103TC0700X	Clinical Psychologist	PY6274	FL

General Provider Information

NPI Number	:	1902810153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA LYNN FRIEDMAN PH.D.

Provider Business Mailing Address
First Line	:	14627 VILLAGE GLEN CIR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2733
Country	:	US
Telephone Number	:	813-928-6895
Fax Number	:

Provider Business Practice Location Address
First Line	:	12169 W LINEBAUGH AVE
Second Line	:	WESTCHASE
City	:	TAMPA
State	:	FL
Zip	:	33626-1732
Country	:	US
Telephone Number	:	813-928-6895
Fax Number	:

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/29/2007

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