Healthcare Provider Details

I. General information

NPI: 1134627391
Provider Name (Legal Business Name): ENZO L ABAD, D.O., P.L.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 01/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182 E 49TH ST
HIALEAH FL
33013-1853
US

IV. Provider business mailing address

182 E 49TH ST
HIALEAH FL
33013-1853
US

V. Phone/Fax

Practice location:
  • Phone: 305-512-4460
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: ENZO LUIS ABAD
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 305-512-4460