Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | ME60516 | FL |
NPI | 1184623068 |
---|---|
Provider Name | Dr. Robert Michael Friedmeyer |
First Address | Clearwater, FL 33759-3012 |
Second Address | Valrico, FL 33596-6403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2005 |
Last Update Date | 26/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
280296100 | (05) | FL |
E24174 | (02) | FL |