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General NPI Number Information
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NPI Number | 1457543746
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Entity Type | Individual
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Provider Name | IVEL CRISTINA DE FREITAS M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 03/28/2020
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Provider Practice Location Address
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Address Line | 4765 SW 148TH AVE STE 404
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City | DAVIE
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State | FL
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Zip | 33330-2128
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Country | US
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Telephone | 203-300-0147
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Fax | 954-634-4293
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Provider Business Mailing Address
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Address Line | 6030 REESE RD APT 406
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City | DAVIE
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State | FL
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Zip | 33314-1243
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Country | US
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Telephone | 305-393-2477
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Fax | 954-634-4293
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME107216
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License Number State | FL
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