Provider Demographics
NPI:1013957356
Name:FRYDMAN, JARROD MARC (DO)
Entity Type:Individual
Prefix:DR
First Name:JARROD
Middle Name:MARC
Last Name:FRYDMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:350 N PINE ISLAND RD
Mailing Address - Street 2:SUITE #302
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1849
Mailing Address - Country:US
Mailing Address - Phone:954-581-8272
Mailing Address - Fax:954-581-8382
Practice Address - Street 1:350 N PINE ISLAND RD
Practice Address - Street 2:SUITE #302
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1849
Practice Address - Country:US
Practice Address - Phone:954-581-8272
Practice Address - Fax:954-581-8382
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8247207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL06276ZMedicare ID - Type Unspecified