Provider Demographics
NPI:1033105770
Name:ALAN R FREEDMAN DC PA
Entity Type:Organization
Organization Name:ALAN R FREEDMAN DC PA
Other - Org Name:ALAN R FREDMAN DC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:FREEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-433-0300
Mailing Address - Street 1:190 S UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-2234
Mailing Address - Country:US
Mailing Address - Phone:954-433-0300
Mailing Address - Fax:954-433-8268
Practice Address - Street 1:190 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-2234
Practice Address - Country:US
Practice Address - Phone:954-433-0300
Practice Address - Fax:954-433-8268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006528111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019191600Medicaid
U41675Medicare UPIN