Provider Demographics
NPI:1215067459
Name:M FELIX FRESHWATER MD PA
Entity type:Organization
Organization Name:M FELIX FRESHWATER MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:M
Authorized Official - Middle Name:FELIX
Authorized Official - Last Name:FRESHWATER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-670-9988
Mailing Address - Street 1:9155 S DADELAND BLVD
Mailing Address - Street 2:STE 1404
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2739
Mailing Address - Country:US
Mailing Address - Phone:305-670-9988
Mailing Address - Fax:305-670-0770
Practice Address - Street 1:9155 S DADELAND BLVD
Practice Address - Street 2:STE 1404
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-2739
Practice Address - Country:US
Practice Address - Phone:305-670-9988
Practice Address - Fax:305-670-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME315022082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty