MEDICARE: EDDI ANN FREEMAN M.S. CCC-SLP

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	235Z00000X	Speech-Language Pathologist	SA 2079	FL

General Provider Information

NPI Number	:	1740508860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDDI ANN FREEMAN M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	4288 S DOUGLAS RD
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-6850
Country	:	US
Telephone Number	:	305-992-7188
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 S BAYSHORE DR
Second Line	:	SUITE 401
City	:	COCONUT GROVE
State	:	FL
Zip	:	33133-5309
Country	:	US
Telephone Number	:	305-992-7188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2010
Last Update Date	:	05/13/2010

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