Healthcare Provider Details

I. General information

NPI: 1215867999
Provider Name (Legal Business Name): JOSEPH N ABADIOTAKIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 NEWELL DR
GAINESVILLE FL
32610-3011
US

IV. Provider business mailing address

8217 HORSEBIT CIR
JACKSONVILLE FL
32219-3545
US

V. Phone/Fax

Practice location:
  • Phone: 732-616-8850
  • Fax:
Mailing address:
  • Phone: 732-616-8850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: