Provider Demographics
NPI:1356401285
Name:RHEUMATOLOGY ASSOCIATES OF CENTRAL FLORIDA PA
Entity type:Organization
Organization Name:RHEUMATOLOGY ASSOCIATES OF CENTRAL FLORIDA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-859-4540
Mailing Address - Street 1:3160 SOUTHGATE COMMERCE BLVD
Mailing Address - Street 2:SUITE30
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-8549
Mailing Address - Country:US
Mailing Address - Phone:407-859-4540
Mailing Address - Fax:407-859-3815
Practice Address - Street 1:3160 SOUTHGATE COMMERCE BLVD
Practice Address - Street 2:SUITE30
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-8549
Practice Address - Country:US
Practice Address - Phone:407-859-4540
Practice Address - Fax:407-859-3815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0039761174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL72313Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER
FL72313Medicare PIN