Healthcare Provider Details

I. General information

NPI: 1295318301
Provider Name (Legal Business Name): ISABEL ANN FREEMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ISABEL ANN DENNIS PA-C

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9320 STATE ROAD 54
TRINITY FL
34655-1808
US

IV. Provider business mailing address

PO BOX 102222
ATLANTA GA
30368-2222
US

V. Phone/Fax

Practice location:
  • Phone: 727-842-8411
  • Fax: 877-917-2336
Mailing address:
  • Phone: 239-274-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9114147
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9114147
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: