Provider Demographics
NPI:1306848726
Name:FREEMAN, OLGA (MD)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13641 METROPOLIS AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4433
Mailing Address - Country:US
Mailing Address - Phone:239-225-7261
Mailing Address - Fax:239-225-7945
Practice Address - Street 1:13641 METROPOLIS AVE STE 101
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4433
Practice Address - Country:US
Practice Address - Phone:239-225-7261
Practice Address - Fax:239-225-7945
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0068876207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAC380OtherMEDICARE
FLAC380OtherMEDICARE
FLG14933Medicare UPIN