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General NPI Number Information
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NPI Number | 1053621086
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Entity Type | Organization
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Legal Business Name | MITCHELL J FREED MD PL
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Dates
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Enumeration Date | 10/08/2010
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Last Update Date | 10/08/2010
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Provider Practice Location Address
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Address Line | 2501 N ORANGE AVE SUITE 505
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City | ORLANDO
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State | FL
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Zip | 32804-4603
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Country | US
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Telephone | 407-898-2924
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Fax | 407-894-5387
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Provider Business Mailing Address
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Address Line | 2501 N ORANGE AVE SUITE 505
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City | ORLANDO
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State | FL
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Zip | 32804-4603
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Country | US
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Telephone | 407-898-2924
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Fax | 407-894-5387
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MITCHELL J FREED
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Credential | M.D.
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Telephone | 407-898-2924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME53196
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License Number State | FL
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