Provider Demographics
NPI:1861082513
Name:FREEMAN, CYNTHIA L (DME)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:DME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6923 BISMARCK RD
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32927-3955
Mailing Address - Country:US
Mailing Address - Phone:407-761-6238
Mailing Address - Fax:
Practice Address - Street 1:6923 BISMARCK RD
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32927-3955
Practice Address - Country:US
Practice Address - Phone:407-761-6238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBB29026174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL844109060Other844109060