Provider Demographics
NPI:1477534303
Name:FREILICH, ELI H (MD)
Entity Type:Individual
Prefix:
First Name:ELI
Middle Name:H
Last Name:FREILICH
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 1:616 E ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3342
Mailing Address - Country:US
Mailing Address - Phone:727-443-0611
Mailing Address - Fax:727-461-5493
Practice Address - Street 1:616 E ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3342
Practice Address - Country:US
Practice Address - Phone:727-443-0611
Practice Address - Fax:727-461-5493
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0032709207RP1001X, 207RC0200X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
30225YMedicare ID - Type Unspecified
30225YMedicare PIN
FLD53901Medicare UPIN