| Entity Name: | ROBERT A. FREEDMAN, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Aug 1986 (38 years ago) |
| Document Number: | J30772 |
| FEI/EIN Number | 592694781 |
| Address: | 1160 Kane Concourse, Bay Harbor Island, FL, 33154, US |
| Mail Address: | 1160 Kane Concourse, Bay Harbor Island, FL, 33154, US |
| ZIP code: | 33154 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518236132 | 2011-12-28 | 2021-07-21 | 1160 96TH ST STE 403, BAY HARBOR ISLANDS, FL, 331542059, US | 1160 KANE CONCOURSE, SUITE 403, BAY HARBOR ISLANDS, FL, 331542053, US | |||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||
| Phone | +1 305-861-8126 |
| Fax | 3058618168 |
Authorized person
| Name | DR. ROBERT ALAN FREEDMAN |
| Role | PRESIDENT |
| Phone | 3058618126 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME41024 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207RI0200X - Infectious Disease Physician |
| License Number | ME41024 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 052210400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FREEDMAN ROBERT A | Agent | 1160 Kane Concourse, Bay Harbor Island, FL, 33154 |
| Name | Role | Address |
|---|---|---|
| FREEDMAN, ROBERT A. | President | 10350 W BAY HARBOR DRIVE, BAY HARBOR ISLANDS, FL, 33154 |
| Name | Role | Address |
|---|---|---|
| FREEDMAN, ROBERT A. | Director | 10350 W BAY HARBOR DRIVE, BAY HARBOR ISLANDS, FL, 33154 |
| FREEDMAN, RANDY | Director | 10350 W BAY HARBOR DRIVE, BAY HARBOR ISLANDS, FL, 33154 |
| Name | Role | Address |
|---|---|---|
| FREEDMAN, ROBERT A. | Secretary | 10350 W BAY HARBOR DRIVE, BAY HARBOR ISLANDS, FL, 33154 |
| Name | Role | Address |
|---|---|---|
| FREEDMAN, RANDY | Vice President | 10350 W BAY HARBOR DRIVE, BAY HARBOR ISLANDS, FL, 33154 |
| Name | Role | Address |
|---|---|---|
| FREEDMAN, RANDY | Treasurer | 10350 W BAY HARBOR DRIVE, BAY HARBOR ISLANDS, FL, 33154 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2012-09-20 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
