Provider Demographics
NPI:1871703090
Name:FREEMAN, MONICA MITCHELL (PT)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:MITCHELL
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2006
Mailing Address - Country:US
Mailing Address - Phone:850-477-8874
Mailing Address - Fax:850-477-8865
Practice Address - Street 1:5330 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2006
Practice Address - Country:US
Practice Address - Phone:850-477-8874
Practice Address - Fax:850-477-8865
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20207225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBU313ZMedicare PIN