MEDICARE: STEPHEN R FRESHLEY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA104686	FL

General Provider Information

NPI Number	:	1245157049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN R FRESHLEY

Provider Business Mailing Address
First Line	:	1846 EMILY DR
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33884-0002
Country	:	US
Telephone Number	:	404-692-2389
Fax Number	:

Provider Business Practice Location Address
First Line	:	1846 EMILY DR
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33884-0002
Country	:	US
Telephone Number	:	404-692-2389
Fax Number	:

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

Provider Enumeration Date	:	07/01/2026
Last Update Date	:	07/01/2026

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Directions to “ STEPHEN R FRESHLEY ” Practice Location

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