Inez Gwendolyn Freeman, Robert Lee Freeman

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

6906248 Issued in FL

Legal business name

INEZ GWENDOLYN FREEMAN, ROBERT LEE FREEMAN

Doing business as

Inez Gwendolyn Freeman

Practice address

1771 Halfmoon St NW
Palm Bay, FL 32907-9220

Phone

(321) 956-3190

NPI assigned

Jul 17, 2014

Last updated

Jul 17, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Inez Gwendolyn Freeman

Title

Owner

Phone

(321) 956-3190

Specialties & licenses 1

Addresses

Other names 1

• Inez Gwendolyn Freeman Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1205243607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 HALFMOON ST NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329079220",
            "telephone_number": "321-956-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 HALFMOON ST NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329079220",
            "telephone_number": "321-956-3190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INEZ GWENDOLYN FREEMAN, ROBERT LEE FREEMAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "INEZ",
        "authorized_official_middle_name": "GWENDOLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-956-3190",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inez Gwendolyn Freeman",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.