Provider Demographics
NPI:1649273327
Name:FRIEDLAND, EDWARD L (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:L
Last Name:FRIEDLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11037
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32524-1037
Mailing Address - Country:US
Mailing Address - Phone:850-444-4700
Mailing Address - Fax:850-444-7497
Practice Address - Street 1:1619 CREIGHTON RD STE 1
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-7152
Practice Address - Country:US
Practice Address - Phone:850-444-4700
Practice Address - Fax:850-434-8144
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.22503207RN0300X
FLME76760207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME76760OtherFLORIDA MEDICAL LICENSURE
FL256009700Medicaid
FL390006485OtherRAILROAD MEDICARE
ALMD.22503OtherALABAMA MEDICAL LICENSURE
ALMD.22503OtherALABAMA MEDICAL LICENSURE
FLE1326TMedicare ID - Type Unspecified
FLE1326UMedicare ID - Type Unspecified
FLME76760OtherFLORIDA MEDICAL LICENSURE
FLME76760OtherFLORIDA MEDICAL LICENSURE