Healthcare Provider Details

I. General information

NPI: 1669939948
Provider Name (Legal Business Name): FREEMAN EXPRESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2019
Last Update Date: 02/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7382 CENTRAL INDUSTRIAL DR
RIVIERA BEACH FL
33404-3426
US

IV. Provider business mailing address

7382 CENTRAL INDUSTRIAL DR
RIVIERA BEACH FL
33404-3426
US

V. Phone/Fax

Practice location:
  • Phone: 561-863-8004
  • Fax: 561-863-8005
Mailing address:
  • Phone: 561-863-8004
  • Fax: 561-863-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HARRY LEONARD FREEMAN JR.
Title or Position: PRESIDENT
Credential: FNP-BC
Phone: 561-291-3579