Provider Demographics
NPI:1154372605
Name:FREEMAN, L NEAL (MD)
Entity type:Individual
Prefix:DR
First Name:L
Middle Name:NEAL
Last Name:FREEMAN
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 1:502 E. NEW HAVEN AVE.
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-5427
Mailing Address - Country:US
Mailing Address - Phone:321-727-2020
Mailing Address - Fax:321-984-9547
Practice Address - Street 1:502 E. NEW HAVEN AVE.
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-5427
Practice Address - Country:US
Practice Address - Phone:321-727-2020
Practice Address - Fax:321-984-9547
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55705207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL166272OtherCCN
FL7268207007OtherCIGNA
FL061257000Medicaid
FL4091512OtherAETNA PPO
FL753837OtherFIRST HEALTH
FL09350OtherBLUE CROSS / BLUE SHIELD
FL2000388OtherAETNA HMO
FL180032657OtherRAILROAD MEDICARE
FL2000388OtherAETNA HMO
FL09350XMedicare PIN