Healthcare Provider Details

I. General information

NPI: 1144130642
Provider Name (Legal Business Name): MEDFREBS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 66TH ST N STE 202
PINELLAS PARK FL
33781-2101
US

IV. Provider business mailing address

7800 66TH ST N STE 202
PINELLAS PARK FL
33781-2101
US

V. Phone/Fax

Practice location:
  • Phone: 727-477-2988
  • Fax: 727-516-4788
Mailing address:
  • Phone: 727-477-2988
  • Fax: 727-516-4788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHARLES E ARCHIE
Title or Position: HR
Credential:
Phone: 757-850-0614