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General NPI Number Information
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NPI Number | 1902335839
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Entity Type | Individual
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Provider Name | NICHOLAS FREEMAN
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Gender | Male
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Dates
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Enumeration Date | 06/05/2017
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 602 COURTLAND ST
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City | ORLANDO
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State | FL
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Zip | 32804-1360
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Country | US
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Telephone | 954-907-9227
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 621376
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City | OVIEDO
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State | FL
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Zip | 32762-1376
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Country | US
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Telephone | 954-907-9227
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7576-C
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW14501
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License Number State | FL
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