Provider Demographics
NPI:1992821821
Name:FREEMAN, RHONDA QUARNETTA (PHD)
Entity type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:QUARNETTA
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4925 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2834
Mailing Address - Country:US
Mailing Address - Phone:954-981-3850
Mailing Address - Fax:954-981-3889
Practice Address - Street 1:4925 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-2834
Practice Address - Country:US
Practice Address - Phone:954-981-3850
Practice Address - Fax:954-981-3889
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6252103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54650BMedicare ID - Type UnspecifiedMY MEDICARE NUMBER