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General NPI Number Information
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NPI Number | 1487819942
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE ASSOCIATES OF SOUTH BEACH, LLC
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Dates
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Enumeration Date | 07/24/2008
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 2801 FLORIDA AVE SUITE 10
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City | MIAMI
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State | FL
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Zip | 33133-1905
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Country | US
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Telephone | 305-534-8300
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Fax | 305-534-6445
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Provider Business Mailing Address
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Address Line | 1450 MERIDIAN AVE SUITE 10
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City | MIAMI BEACH
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State | FL
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Zip | 33139-8059
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Country | US
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Telephone | 305-534-8300
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Fax | 305-534-6445
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD MICHAEL FREEMAN
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Credential | PHD, ARNP, BC
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Telephone | 305-534-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 2987482
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2987482
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License Number State | FL
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