MEDICARE: ELI FRIEDMAN DDS

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	:	1952702755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELI FRIEDMAN DDS

Provider Business Mailing Address
First Line	:	9825 W SAMPLE RD
Second Line	:	SUITE 100
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4040
Country	:	US
Telephone Number	:	305-333-7844
Fax Number	:

Provider Business Practice Location Address
First Line	:	9825 W SAMPLE RD
Second Line	:	SUITE 100
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4040
Country	:	US
Telephone Number	:	305-333-7844
Fax Number	:

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

Provider Enumeration Date	:	09/11/2014
Last Update Date	:	09/11/2014

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