Healthcare Provider Details

I. General information

NPI: 1609432061
Provider Name (Legal Business Name): TONY THOMAS ABRAHAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2019
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 SW 216TH ST
CUTLER BAY FL
33190-1003
US

IV. Provider business mailing address

7529 SW 109TH CT
MIAMI FL
33173-2730
US

V. Phone/Fax

Practice location:
  • Phone: 305-252-5899
  • Fax: 305-317-5971
Mailing address:
  • Phone: 813-618-9567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME152291
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA181335
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME152291
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberTRN28254
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: