MEDICARE: DR. ABRAHA TADDESE M.D.

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	2085R0202X	Diagnostic Radiology Physician	R3603	TX
2	2085R0202X	Diagnostic Radiology Physician	D84319	MD
3	2085R0202X	Diagnostic Radiology Physician	TRN8495	FL

General Provider Information

NPI Number	:	1740416189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABRAHA TADDESE M.D.

Provider Business Mailing Address
First Line	:	7928 EAST DR STE 2002
Second Line	:
City	:	NORTH BAY VILLAGE
State	:	FL
Zip	:	33141-5685
Country	:	US
Telephone Number	:	305-742-1235
Fax Number	:

Provider Business Practice Location Address
First Line	:	7928 EAST DR STE 2002
Second Line	:
City	:	NORTH BAY VILLAGE
State	:	FL
Zip	:	33141-5685
Country	:	US
Telephone Number	:	305-742-1235
Fax Number	:

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

Provider Enumeration Date	:	05/29/2009
Last Update Date	:	05/01/2018

Similar Medicare Providers

1558811851 — BODY ARMOR SPORTS AND ORTHOPEDIC PHYSICAL THERAPY
Practice Location Address:

7928 EAST DR APT 2001
NORTH BAY VILLAGE, FL
33141-5685

Practice Phone: 310-405-1945
Practice Fax:

1104462431 — SARAH ST. JAMES MS OTR/L
Practice Location Address:

24 SETTLERS WAY
BUZZARDS BAY, MA
02532-5685

Practice Phone: 508-737-0261
Practice Fax:

1043531486 — KIM J CORL
Practice Location Address:

5685 BLIFFERT ST
NORTH PORT, FL
34287-2874

Practice Phone: 941-445-8232
Practice Fax:

1730625047 — DOUGLAS ACCOUNTIUS RN, MBA, AG-ACNP-BC
Practice Location Address:

NORTHERN NAVAJO MEDICAL CENTER , HIGHWAY 491 NORTH
SHIPROCK, NM
87420-5685

Practice Phone: 505-368-6462
Practice Fax: 505-365-6547

1609271626 — CORINNE ELIZABETH KUSTRON COTA/RD
Practice Location Address:

5685 EDEN VILLAGE DR
INDIANAPOLIS, IN
46254-1203

Practice Phone: 219-789-9505
Practice Fax:

1700283934 — MALYSSA LOVELACE
Practice Location Address:

5685 EDEN VILLAGE DR
INDIANAPOLIS, IN
46254-1203

Practice Phone: 317-297-7880
Practice Fax:

Directions to “ DR. ABRAHA TADDESE M.D.” 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 © 2007-2025 (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.