Provider Demographics
NPI:1942998869
Name:FREELAND VISION LLC
Entity type:Organization
Organization Name:FREELAND VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KLAUS
Authorized Official - Middle Name:
Authorized Official - Last Name:FREELAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-380-5486
Mailing Address - Street 1:331 SWEET BAY CIRCLE
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458
Mailing Address - Country:US
Mailing Address - Phone:941-380-5486
Mailing Address - Fax:937-956-7708
Practice Address - Street 1:1085 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373
Practice Address - Country:US
Practice Address - Phone:937-505-8585
Practice Address - Fax:937-956-7708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-27
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0017866Medicaid