MEDICARE: EVANGELINE ABRAHAM

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	225X00000X	Occupational Therapist
2	225XP0200X	Pediatric Occupational Therapist	21064	FL

General Provider Information

NPI Number	:	1407612393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVANGELINE ABRAHAM

Provider Business Mailing Address
First Line	:	4841 WILLIAMSTOWN BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-3704
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4841 WILLIAMSTOWN BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-3704
Country	:	US
Telephone Number	:	207-329-5420
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2024
Last Update Date	:	02/27/2024

Similar Medicare Providers

1487127791 — TIFFANY LAUREN ALLY
Practice Location Address:

2044 BROKEN ARROW TRL N
LAKELAND, FL
33813-3704

Practice Phone: 863-640-8791
Practice Fax:

1891626446 — MOHAMMAD JACOB NAZZAL RN
Practice Location Address:

2016 HARVEST LANDING CIR
LAKELAND, FL
33810-5177

Practice Phone: 214-682-4148
Practice Fax:

1831849199 — ROXANA MARRERO
Practice Location Address:

1516 MARK LN
LAKELAND, FL
33810-3843

Practice Phone: 305-972-2437
Practice Fax:

1487581716 — EAGLE PHARMACY LLC
Practice Location Address:

330 EAGLES LANDING DR STE 260
LAKELAND, FL
33810-3041

Practice Phone: 202-930-4242
Practice Fax: 202-930-4243

1801767835 — LUZ THERAPY LLC
Practice Location Address:

7823 ABAGAIL DR
LAKELAND, FL
33810-1385

Practice Phone: 863-380-9813
Practice Fax:

1447180609 — HEALING WHEELS TRANSIT
Practice Location Address:

4035 DOVER TERRACE DR
LAKELAND, FL
33810-2416

Practice Phone: 863-663-7940
Practice Fax:

Directions to “ EVANGELINE ABRAHAM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.