Provider Demographics
NPI:1912334681
Name:FRIEDMAN SPINE AND PAIN CLINIC OF FLORIDA INC
Entity Type:Organization
Organization Name:FRIEDMAN SPINE AND PAIN CLINIC OF FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JARROD
Authorized Official - Middle Name:D
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-859-0185
Mailing Address - Street 1:33 SE 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-6121
Mailing Address - Country:US
Mailing Address - Phone:561-859-0185
Mailing Address - Fax:561-409-3995
Practice Address - Street 1:33 SE 8TH ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-6121
Practice Address - Country:US
Practice Address - Phone:561-859-0185
Practice Address - Fax:561-409-3995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME107418208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty