Healthcare Provider Details
I. General information
NPI: 1295350627
Provider Name (Legal Business Name): FREEDOM NOW, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/11/2020
Last Update Date: 09/01/2021
Certification Date: 09/01/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
236 SE 23RD AVE
BOYNTON BEACH FL
33435-7620
US
IV. Provider business mailing address
14000 S MILITARY TRL STE 208
DELRAY BEACH FL
33484-2654
US
V. Phone/Fax
- Phone: 561-501-5260
- Fax: 954-982-6648
- Phone: 561-501-5260
- Fax: 954-982-6648
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JASON
ROMANO
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 561-565-5628