Basic Information
Provider Information
NPI: 1003004656
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRIEDMAN
FirstName: DEBBIE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MARKENSON
OtherFirstName: DEBBIE
OtherMiddleName: F
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD, PHD
OtherLastNameType: 1
Mailing Information
Address1: 1300 SAWGRASS CORPORATE PKWY
Address2: SUITE 200
City: SUNRISE
State: FL
PostalCode: 333232826
CountryCode: US
TelephoneNumber: 8002433839
FaxNumber:  
Practice Location
Address1: 5325 GREENWOOD AVE
Address2: SUITE 201
City: WEST PALM BEACH
State: FL
PostalCode: 334072452
CountryCode: US
TelephoneNumber: 5618449858
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/09/2007
LastUpdateDate: 08/19/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XMD036951DCN Allopathic & Osteopathic PhysiciansPediatrics 
2080P0202XME119401FLY Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
2080P0202X25MA08956000NJN Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology

No ID Information.


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