=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780502740
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CMEDDS HOLDINGS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2026
-----------------------------------------------------
Last Update Date | 07/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18206 ROCKPORT PL
-----------------------------------------------------
City | LAKEWOOD RANCH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34211-1169
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-500-9691
-----------------------------------------------------
Fax | 908-430-5610
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 711 S CARSON ST STE 4
-----------------------------------------------------
City | CARSON CITY
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89701-5292
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-975-9819
-----------------------------------------------------
Fax | 908-430-5610
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. PHILIP FREED
-----------------------------------------------------
Credential | MPAS,MPA
-----------------------------------------------------
Telephone | 800-975-9819
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 305S00000X
-----------------------------------------------------
Taxonomy Name | Point of Service
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------