Provider Demographics
NPI:1013948363
Name:FREEDMAN, ALAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:M
Last Name:FREEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4412 W OSBORNE AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-6963
Mailing Address - Country:US
Mailing Address - Phone:813-914-9100
Mailing Address - Fax:239-278-1159
Practice Address - Street 1:4412 W OSBORNE AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-6963
Practice Address - Country:US
Practice Address - Phone:813-914-9100
Practice Address - Fax:239-278-1159
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75116207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL71879ZMedicare PIN
FLG57892Medicare UPIN