Provider Demographics
NPI:1295779080
Name:FRIEDMAN, MINDI (AUD)
Entity type:Individual
Prefix:DR
First Name:MINDI
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MINDI
Other - Middle Name:
Other - Last Name:SOLOMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2510 E SUNSET RD
Mailing Address - Street 2:UNIT 5-260
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3511
Mailing Address - Country:US
Mailing Address - Phone:702-798-0113
Mailing Address - Fax:866-291-5242
Practice Address - Street 1:269 S. FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:FL
Practice Address - Zip Code:33441-4161
Practice Address - Country:US
Practice Address - Phone:954-426-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY993231H00000X
237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL600287100Medicaid
FL40006396OtherPEDIATRIC ASSOCIATES
FL4901381OtherGHI
FLE4419XMedicare PIN