Individual
MS. PENELOPE FRESEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1701 SE HILLMOOR DR, SUITE 5, PORT SAINT LUCIE, FL 34952-7552
(772) 335-0060
Mailing address
2430 SW FALCON CIR, PORT SAINT LUCIE, FL 34953-2922
(772) 873-8800
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9101742
FL
Other
Enumeration date
12/05/2005
Last updated
07/08/2007
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