Healthcare Provider Details

I. General information

NPI: 1831147412
Provider Name (Legal Business Name): PAMELA G FREEMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 04/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3160 SOUTHGATE COMMERCE BLVD STE 30
ORLANDO FL
32806-8549
US

IV. Provider business mailing address

3160 SOUTHGATE COMMERCE BLVD STE 30
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 Code207RR0500X
TaxonomyRheumatology Physician
License NumberME0039761
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: