Provider Demographics
NPI:1518236132
Name:ROBERT A. FREEDMAN, M.D., P.A.
Entity Type:Organization
Organization Name:ROBERT A. FREEDMAN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:FREEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-861-8126
Mailing Address - Street 1:1160 96TH ST STE 403
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2059
Mailing Address - Country:US
Mailing Address - Phone:305-861-8126
Mailing Address - Fax:305-861-8168
Practice Address - Street 1:1160 KANE CONCOURSE
Practice Address - Street 2:SUITE 403
Practice Address - City:BAY HARBOR ISLANDS
Practice Address - State:FL
Practice Address - Zip Code:33154-2053
Practice Address - Country:US
Practice Address - Phone:305-861-8126
Practice Address - Fax:305-861-8168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-28
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME41024207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL052210400Medicaid
FL052210400Medicaid