Provider Demographics
NPI:1902048275
Name:BETH FREEDLAND, D.O., LLC
Entity Type:Organization
Organization Name:BETH FREEDLAND, D.O., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:LORI
Authorized Official - Last Name:FREEDLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-961-5456
Mailing Address - Street 1:7301A W PALMETTO PARK RD
Mailing Address - Street 2:SUITE 301A
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3409
Mailing Address - Country:US
Mailing Address - Phone:561-961-5456
Mailing Address - Fax:561-672-7953
Practice Address - Street 1:7301A W PALMETTO PARK RD
Practice Address - Street 2:SUITE 301A
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3409
Practice Address - Country:US
Practice Address - Phone:561-961-5456
Practice Address - Fax:561-672-7953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8499207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266493300Medicaid
FL266493300Medicaid