Provider Demographics
NPI:1861638280
Name:FREIRE, RODOLFO (MD)
Entity Type:Individual
Prefix:
First Name:RODOLFO
Middle Name:
Last Name:FREIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12264 TAMIAMI TRL E # UNITE201
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34113-7942
Mailing Address - Country:US
Mailing Address - Phone:239-304-9071
Mailing Address - Fax:239-304-9320
Practice Address - Street 1:12264 TAMIAMI TRL E # UNITE201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-7942
Practice Address - Country:US
Practice Address - Phone:239-304-9071
Practice Address - Fax:239-304-9320
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME109303207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine