MEDICARE: ABBUBACCA PARKINSON, DPM, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	PO2944	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376986224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABBUBACCA PARKINSON, DPM, PA

Provider Business Mailing Address
First Line	:	PO BOX 1330
Second Line	:
City	:	ESTERO
State	:	FL
Zip	:	33929-1330
Country	:	US
Telephone Number	:	239-273-8624
Fax Number	:	239-437-4237

Provider Business Practice Location Address
First Line	:	6 NW 35TH AVE
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33993-6932
Country	:	US
Telephone Number	:	239-273-8624
Fax Number	:	239-437-4237

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ABBUBACCA PARKINSON
Credential	:	DPM
Telephone Number	:	239-273-8624

Provider Enumeration Date	:	04/10/2013
Last Update Date	:	09/22/2020

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