Provider Demographics
NPI:1659342897
Name:FRUEHAN, FLORENCE ROBERT (DO)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:ROBERT
Last Name:FRUEHAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 PINE CONE DR
Mailing Address - Street 2:STE 102
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-8686
Mailing Address - Country:US
Mailing Address - Phone:386-445-6191
Mailing Address - Fax:386-445-3916
Practice Address - Street 1:9 PINE CONE DR
Practice Address - Street 2:STE 102
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-8686
Practice Address - Country:US
Practice Address - Phone:386-445-6191
Practice Address - Fax:386-445-3916
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS5359207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B34410Medicare UPIN