Healthcare Provider Details

I. General information

NPI: 1154372605
Provider Name (Legal Business Name): L NEAL FREEMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 E NEW HAVEN AVE
MELBOURNE FL
32901-5427
US

IV. Provider business mailing address

502 E NEW HAVEN AVE
MELBOURNE FL
32901-5427
US

V. Phone/Fax

Practice location:
  • Phone: 321-727-2020
  • Fax: 321-726-4074
Mailing address:
  • Phone: 321-727-2020
  • Fax: 321-726-4074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License NumberME55705
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: