Basic Information
| Provider Information | |||||||||
| NPI: | 1629307400 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JACOB J. FREIMAN, M.D., P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 HERITAGE DR | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | JUPITER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334583097 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616247472 | ||||||||
| FaxNumber: | 5616273006 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 HERITAGE DR | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | JUPITER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334583097 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616247472 | ||||||||
| FaxNumber: | 5616273006 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2009 | ||||||||
| LastUpdateDate: | 12/08/2009 | ||||||||
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| AuthorizedOfficialLastName: | FREIMAN | ||||||||
| AuthorizedOfficialFirstName: | JACOB | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5616247472 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QH0100X | ME102509 | FL | Y | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
No ID Information.