Provider Demographics
NPI:1518362557
Name:JARROD FRIEDMAN
Entity Type:Organization
Organization Name:JARROD FRIEDMAN
Other - Org Name:JARROD FRIEDMAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEBORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLCOMBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-795-0018
Mailing Address - Street 1:5061 VIA DE AMALFI DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2429
Mailing Address - Country:US
Mailing Address - Phone:561-795-0018
Mailing Address - Fax:561-721-4142
Practice Address - Street 1:5061 VIA DE AMALFI DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2429
Practice Address - Country:US
Practice Address - Phone:561-795-0018
Practice Address - Fax:561-721-4142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME107418251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME107418OtherME107418