Provider Demographics
NPI:1780749481
Name:FRIEDMAN, STUART ANDREW (MD)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:ANDREW
Last Name:FRIEDMAN
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 1:5162 LINTON BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6567
Mailing Address - Country:US
Mailing Address - Phone:561-495-2580
Mailing Address - Fax:561-495-0928
Practice Address - Street 1:5162 LINTON BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6567
Practice Address - Country:US
Practice Address - Phone:561-495-2580
Practice Address - Fax:561-495-0928
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-25
Last Update Date:2020-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38998207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL61217Medicare ID - Type Unspecified
FLD65253Medicare UPIN