Provider Demographics
NPI:1912759309
Name:FRIEDMAN, BENJAMIN ALEXANDER (OD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:ALEXANDER
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5498 BARNSTEAD CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6673
Mailing Address - Country:US
Mailing Address - Phone:561-870-6363
Mailing Address - Fax:
Practice Address - Street 1:5498 BARNSTEAD CIR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-6673
Practice Address - Country:US
Practice Address - Phone:561-870-6363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty