Healthcare Provider Details

I. General information

NPI: 1730886540
Provider Name (Legal Business Name): FREEDOM HEALTH MANAGEMENT GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 05/04/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 AVE PONCE DE LEON STE MZ-E8
SAN JUAN PR
00907-3907
US

IV. Provider business mailing address

1225 AVE PONCE DE LEON STE MZ-E8
SAN JUAN PR
00907-3907
US

V. Phone/Fax

Practice location:
  • Phone: 939-491-1591
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: AWILDA LUQUE GUZMAN
Title or Position: PRESIDENT
Credential:
Phone: 939-491-1591