Basic Information
| Provider Information | |||||||||
| NPI: | 1013141712 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FREIMAN | ||||||||
| FirstName: | JACOB | ||||||||
| MiddleName: | J. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 HERITAGE DR | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | JUPITER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334583000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616247472 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 600 HERITAGE DR | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | JUPITER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334583000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616247472 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2009 | ||||||||
| LastUpdateDate: | 09/14/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | ME102509 | FL | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.