Provider Demographics
NPI:1386861870
Name:FRIEDMAN & GREENHUT, DPM, PA
Entity Type:Organization
Organization Name:FRIEDMAN & GREENHUT, DPM, PA
Other - Org Name:CALLAHAN FOOT & ANKLE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:904-879-2552
Mailing Address - Street 1:PO BOX 1578
Mailing Address - Street 2:
Mailing Address - City:CALLAHAN
Mailing Address - State:FL
Mailing Address - Zip Code:32011-1578
Mailing Address - Country:US
Mailing Address - Phone:904-879-2552
Mailing Address - Fax:904-879-6360
Practice Address - Street 1:2561 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4722
Practice Address - Country:US
Practice Address - Phone:904-308-7909
Practice Address - Fax:904-308-4099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL87736Medicare ID - Type UnspecifiedDR FRIEDMAN
FLU76485Medicare UPIN
FLU90307Medicare UPIN
FL65738Medicare ID - Type UnspecifiedDR LAPKOWICZ
FL65613Medicare ID - Type UnspecifiedDR HERBST
FLT55524Medicare UPIN
FL87801Medicare ID - Type UnspecifiedDR GREENHUT
FLU18387Medicare UPIN