Provider Demographics
NPI:1831252428
Name:FRIDMAN, JUAN ARTURO (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:ARTURO
Last Name:FRIDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 N KENDALL DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2118
Mailing Address - Country:US
Mailing Address - Phone:786-596-7232
Mailing Address - Fax:786-596-2769
Practice Address - Street 1:8900 N KENDALL DR
Practice Address - Street 2:DEPARTMENT OF MEDICAL EDUCATION
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2118
Practice Address - Country:US
Practice Address - Phone:786-596-7232
Practice Address - Fax:786-596-2769
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 27398208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD-63479Medicare UPIN
FL95479Medicare ID - Type Unspecified