Provider Demographics
NPI:1770030942
Name:FRIEDMAN, STACY (DHS)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:DHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11886 FOXBRIAR LAKE TRL
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33473-7830
Mailing Address - Country:US
Mailing Address - Phone:561-899-7669
Mailing Address - Fax:
Practice Address - Street 1:5700 LAKE WORTH RD STE 110
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3213
Practice Address - Country:US
Practice Address - Phone:561-899-7669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator