MEDICARE: FREJEN CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	AL10051	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447698956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREJEN CORPORATION

Provider Business Mailing Address
First Line	:	1815 ORANGE PICKER ROAD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223
Country	:	US
Telephone Number	:	904-399-8999
Fax Number	:

Provider Business Practice Location Address
First Line	:	2689 ART MUSEUM DRIVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207
Country	:	US
Telephone Number	:	904-399-8999
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FREDDIE MAYONTE ARGUILLA
Credential	:	9048875914
Telephone Number	:	904-887-5914

Provider Enumeration Date	:	06/06/2013
Last Update Date	:	06/06/2013

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Directions to “FREJEN CORPORATION ” Practice Location

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