Provider Demographics
NPI:1043283153
Name:FRIEDMAN, LAWRENCE (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1380
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-1380
Mailing Address - Country:US
Mailing Address - Phone:727-239-3456
Mailing Address - Fax:727-943-3794
Practice Address - Street 1:1831 N BELCHER RD
Practice Address - Street 2:SUITE A-2
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1449
Practice Address - Country:US
Practice Address - Phone:727-797-5500
Practice Address - Fax:727-943-3794
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64984207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
25271PMedicare ID - Type UnspecifiedMEDICARE
F24196Medicare UPIN