Provider Demographics
NPI:1366093262
Name:AFRICAN RELIEF PC
Entity type:Organization
Organization Name:AFRICAN RELIEF PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FREELEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-770-6620
Mailing Address - Street 1:2014 PRINCE DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1033
Mailing Address - Country:US
Mailing Address - Phone:203-770-6620
Mailing Address - Fax:
Practice Address - Street 1:201 8TH ST S STE 303
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6117
Practice Address - Country:US
Practice Address - Phone:203-770-6620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME127514OtherFLORIDA STATE LICENSE