Provider Demographics
NPI:1821146077
Name:FREDA, JAMES PATRICK (RRT-NPS, RPFT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PATRICK
Last Name:FREDA
Suffix:
Gender:M
Credentials:RRT-NPS, RPFT
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:FREDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JAMES FREDA, RRT-NPS
Mailing Address - Street 1:4456 TAMIAMI TRL STE B15
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33980-2136
Mailing Address - Country:US
Mailing Address - Phone:954-257-5931
Mailing Address - Fax:954-583-5949
Practice Address - Street 1:4456 TAMIAMI TRL STE B15
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33980-2136
Practice Address - Country:US
Practice Address - Phone:954-257-5931
Practice Address - Fax:954-583-5949
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT43922279P1006X, 2279P3900X, 2279H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome HealthGroup - Single Specialty
No2279P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Function Technologist
Yes2279P3900XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredNeonatal/Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL884342200Medicaid