MEDICARE: LATONYA FREEMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	253Z00000X	In Home Supportive Care Agency
2	372600000X	Adult Companion
3	376J00000X	Homemaker
4	251E00000X	Home Health Agency	FL

General Provider Information

NPI Number	:	1063097434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATONYA FREEMAN

Provider Business Mailing Address
First Line	:	7316 WILDER AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32208-4270
Country	:	US
Telephone Number	:	904-612-9079
Fax Number	:

Provider Business Practice Location Address
First Line	:	7316 WILDER AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32208-4270
Country	:	US
Telephone Number	:	904-612-9079
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2021
Last Update Date	:	03/16/2021

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Directions to “ LATONYA FREEMAN ” Practice Location

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