Provider Demographics
NPI:1912998808
Name:FRIEDMAN, STEPHEN L (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:L
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 1:1865 VETERANS PARK DR STE 101
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0447
Mailing Address - Country:US
Mailing Address - Phone:239-254-7778
Mailing Address - Fax:855-959-1692
Practice Address - Street 1:150 TAMIAMI TRL N STE 1
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102
Practice Address - Country:US
Practice Address - Phone:239-331-8551
Practice Address - Fax:855-959-1692
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 71533207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
41721OtherBLUE CROSS BLUE SHIELD
41721OtherBLUE CROSS BLUE SHIELD
E70714Medicare UPIN
FL253155100Medicaid