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Individual

DESIRAE FRIEND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
755 RINEHART RD, LAKE MARY, FL 32746
(407) 320-8100
(407) 320-8110
Mailing address
755 RINEHART RD, LAKE MARY, FL 32746-4874
(407) 320-8100
(407) 320-8110

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0536749
KS
207Q00000X
Family Medicine Physician
Primary
OS15979
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201128020B
KS
Enumeration date
06/08/2012
Last updated
09/13/2019
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