Healthcare Provider Details

I. General information

NPI: 1356401285
Provider Name (Legal Business Name): RHEUMATOLOGY ASSOCIATES OF CENTRAL FLORIDA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 09/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3160 SOUTHGATE COMMERCE BLVD SUITE30
ORLANDO FL
32806-8549
US

IV. Provider business mailing address

3160 SOUTHGATE COMMERCE BLVD SUITE30
ORLANDO FL
32806-8549
US

V. Phone/Fax

Practice location:
  • Phone: 407-859-4540
  • Fax: 407-859-3815
Mailing address:
  • Phone: 407-859-4540
  • Fax: 407-859-3815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME0039761
License Number StateFL

VIII. Authorized Official

Name: DR. PAMELA GAIL FREEMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 407-859-4540