Healthcare Provider Details

I. General information

NPI: 1629332242
Provider Name (Legal Business Name): MEGAN E ABAD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN E BOBIANSKI PA

II. Dates (important events)

Enumeration Date: 06/28/2012
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 DOCTORS DR
ENGLEWOOD FL
34223-3992
US

IV. Provider business mailing address

PO BOX 102222
ATLANTA GA
30368-2222
US

V. Phone/Fax

Practice location:
  • Phone: 941-460-1300
  • Fax: 866-504-3674
Mailing address:
  • Phone: 239-274-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9111158
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number4417
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: