Healthcare Provider Details

I. General information

NPI: 1992821821
Provider Name (Legal Business Name): RHONDA QUARNETTA FREEMAN PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 04/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4925 SHERIDAN ST
HOLLYWOOD FL
33021-2834
US

IV. Provider business mailing address

4925 SHERIDAN ST
HOLLYWOOD FL
33021-2834
US

V. Phone/Fax

Practice location:
  • Phone: 954-981-3850
  • Fax: 954-981-3889
Mailing address:
  • Phone: 954-981-3850
  • Fax: 954-981-3889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY6252
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: