Basic Information
| Provider Information | |||||||||
| NPI: | 1902313901 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FRIEDMAN PAIN MANAGEMENT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 102 S EVERS ST STE 102 | ||||||||
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| City: | PLANT CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335635403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8137547756 | ||||||||
| FaxNumber: | 8137547565 | ||||||||
| Practice Location | |||||||||
| Address1: | 311 TAMIAMI TRL N STE 200 | ||||||||
| Address2: | |||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341025887 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8137547756 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2017 | ||||||||
| LastUpdateDate: | 12/29/2017 | ||||||||
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| AuthorizedOfficialLastName: | FRIEDMAN | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2392724449 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0014X | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
No ID Information.