Provider Demographics
NPI:1386697183
Name:FREEDMAN, ROBERT ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALAN
Last Name:FREEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1160 96TH ST STE 403
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2059
Mailing Address - Country:US
Mailing Address - Phone:305-861-8126
Mailing Address - Fax:305-861-8168
Practice Address - Street 1:1160 96TH ST STE 403
Practice Address - Street 2:
Practice Address - City:BAY HARBOR ISLANDS
Practice Address - State:FL
Practice Address - Zip Code:33154-2059
Practice Address - Country:US
Practice Address - Phone:305-861-8126
Practice Address - Fax:305-861-8168
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME41024174400000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL61518OtherBLUE CROSS BLUE SHIELD
FL440001698OtherRAILROAD MEDICARE
FL90048OtherBLUE CROSS EMPIRE
FL9200058OtherUNITED HEALTHCARE
FL101332OtherAVMED
FL052210400Medicaid
FL38279OtherBLUE CROSS MEDIGAP
FL2694781OtherOXFORD
FL592694781OtherTAX ID
FLNC444OtherWELLCARE
FL222224OtherAMERIGROUP