Basic Information
| Provider Information | |||||||||
| NPI: | 1659667012 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FREIDL | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 44008 | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322314008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043831010 | ||||||||
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| Practice Location | |||||||||
| Address1: | UF HEALTH - NORTH | ||||||||
| Address2: | 15255 MAX LEGGETT PARKWAY - SUITE 6600 | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043831000 | ||||||||
| FaxNumber: | 9043831743 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2011 | ||||||||
| LastUpdateDate: | 07/02/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | MD442913 | PA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 66490 | GA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | ME135326 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.