Provider Demographics
NPI:1588701379
Name:FREEDMAN, SAMUEL M (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:M
Last Name:FREEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:601 N FLAMINGO RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1015
Mailing Address - Country:US
Mailing Address - Phone:954-447-1198
Mailing Address - Fax:954-447-9893
Practice Address - Street 1:601 N FLAMINGO RD STE 207
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1009
Practice Address - Country:US
Practice Address - Phone:954-447-1198
Practice Address - Fax:954-447-9893
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME665542080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF91222Medicare UPIN