Provider Demographics
NPI:1033269097
Name:FREEDMAN, EILEEN
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:
Last Name:FREEDMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 SW COTTONWOOD CV
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2002
Mailing Address - Country:US
Mailing Address - Phone:772-873-0027
Mailing Address - Fax:
Practice Address - Street 1:1317 SW COTTONWOOD CV
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2002
Practice Address - Country:US
Practice Address - Phone:772-873-0027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator