Provider Demographics
NPI:1831903129
Name:FREEMAN, RICHARD LEE II
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:LEE
Last Name:FREEMAN
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4657 GULF BREEZE PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-9166
Mailing Address - Country:US
Mailing Address - Phone:850-677-0270
Mailing Address - Fax:
Practice Address - Street 1:4657 GULF BREEZE PKWY STE C
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-9166
Practice Address - Country:US
Practice Address - Phone:850-677-0270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-1205019OtherBACB