Provider Demographics
NPI:1639501372
Name:RECOVERY RESOURCES OF FLORIDA, L.L.C.
Entity Type:Organization
Organization Name:RECOVERY RESOURCES OF FLORIDA, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-851-9528
Mailing Address - Street 1:8839 BRYAN DAIRY RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-1203
Mailing Address - Country:US
Mailing Address - Phone:727-851-9528
Mailing Address - Fax:727-851-9529
Practice Address - Street 1:8839 BRYAN DAIRY RD
Practice Address - Street 2:SUITE 215
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1203
Practice Address - Country:US
Practice Address - Phone:727-851-9528
Practice Address - Fax:727-851-9529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5789207LA0401X
FLME77670207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction MedicineGroup - Multi-Specialty
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty