Provider Demographics
NPI:1194919050
Name:FREEMAN, EDWARD MICHAEL (PHD, ARNP)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:MICHAEL
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:PHD, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 W FLAGLER ST STE 900
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-1807
Mailing Address - Country:US
Mailing Address - Phone:786-385-1486
Mailing Address - Fax:786-807-6804
Practice Address - Street 1:11601 BISCAYNE BLVD STE 304
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3151
Practice Address - Country:US
Practice Address - Phone:786-385-1486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2987482363LA2200X
FLAPRN29874882084P0802X, 2080P0008X
1744R1102X
CA419395363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No1744R1102XOther Service ProvidersSpecialistResearch Study
No2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLYO73KAMedicare PIN
FLQ54915Medicare UPIN