Provider Demographics
NPI:1023205440
Name:VARNER, FREDDIE LEE III
Entity Type:Individual
Prefix:
First Name:FREDDIE
Middle Name:LEE
Last Name:VARNER
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1761 W FLETCHER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-1820
Mailing Address - Country:US
Mailing Address - Phone:813-270-2808
Mailing Address - Fax:813-792-8594
Practice Address - Street 1:1761 W FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-1820
Practice Address - Country:US
Practice Address - Phone:813-270-2808
Practice Address - Fax:813-792-8594
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-30
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies