Healthcare Provider Details

I. General information

NPI: 1831130699
Provider Name (Legal Business Name): LOUIS P. FREEMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

2555 PONCE DE LEON BLVD 4TH FLOOR
CORAL GABLES FL
33134-6010
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-1960
  • Fax:
Mailing address:
  • Phone: 305-702-5135
  • Fax: 305-441-2144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME87674
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: