Healthcare Provider Details

I. General information

NPI: 1063999738
Provider Name (Legal Business Name): LATOYA GAUNTLETT-FREEMAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2018
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 SARONA CIR
ROYAL PALM BEACH FL
33411-4320
US

IV. Provider business mailing address

106 SARONA CIR
ROYAL PALM BEACH FL
33411-4320
US

V. Phone/Fax

Practice location:
  • Phone: 631-867-6757
  • Fax: 954-827-2664
Mailing address:
  • Phone:
  • Fax: 954-827-2664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9356739
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF343439
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: