Provider Demographics
NPI:1477581726
Name:FRIEDMAN, LAWRENCE B (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:B
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 NW 12TH AVE
Mailing Address - Street 2:PO BOX 016820 (D-820)
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33101-6820
Mailing Address - Country:US
Mailing Address - Phone:305-243-5880
Mailing Address - Fax:305-243-5956
Practice Address - Street 1:1601 NW 12TH AVE
Practice Address - Street 2:MAILMAN CENTER, SUITE 1055
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-243-5880
Practice Address - Fax:305-243-5956
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME41232208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0407127-00Medicaid
FL0407127-00Medicaid
FLD64932Medicare UPIN