Freeman, Agnes Mae

Freeman, Agnes Mae is an sole proprietor health care provider with primary practice located at 160 Hibiscus Ln , Deltona FL 32738-9335. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Freeman, Agnes Mae can be contacted via phone (407) 792-9678.

Contact Information

Primary practice address
160 Hibiscus Ln Deltona FL 32738-9335
Phone: (407) 792-9678
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X 17200000X Florida
Other Service Providers / Community Health Worker 172V00000X 687652896 Florida

Profile Details

NPI number 1740583426
LBN Legal business name Freeman, Agnes Mae
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 17th, 2010
Last updated Dec 17th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740583426 NPPES
Florida MEDICAID 687652897
Florida MEDICAID 687652896

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