Provider Demographics
NPI:1972278109
Name:CORESMART, INC.
Entity Type:Organization
Organization Name:CORESMART, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JARROD
Authorized Official - Middle Name:D
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-923-9599
Mailing Address - Street 1:5458 TOWN CENTER RD STE 103
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1026
Mailing Address - Country:US
Mailing Address - Phone:561-923-9599
Mailing Address - Fax:561-923-9602
Practice Address - Street 1:5458 TOWN CENTER RD STE 103
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1026
Practice Address - Country:US
Practice Address - Phone:561-923-9599
Practice Address - Fax:561-923-9602
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORESMART, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty