Basic Information
| Provider Information | |||||||||
| NPI: | 1043218407 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRIEDMAN | ||||||||
| FirstName: | ANTONY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2152 ALTON RD | ||||||||
| Address2: | |||||||||
| City: | MIAMI BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059683033 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1100 NW 95TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331502038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058356191 | ||||||||
| FaxNumber: | 3056943649 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2005 | ||||||||
| LastUpdateDate: | 06/13/2008 | ||||||||
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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 | 207P00000X | ME92595 | FL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | ME92595 | 01 | FL | MEDICAL LICENSE | OTHER | 272183000 | 05 | FL | MEDICAID |