Healthcare Provider Details

I. General information

NPI: 1467788034
Provider Name (Legal Business Name): ENZO L ABAD DO PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2009
Last Update Date: 12/15/2022
Certification Date: 12/15/2022
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: 305-512-4460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberOS 9611
License Number StateFL

VIII. Authorized Official

Name: DR. ENZO LUIS ABAD
Title or Position: MANAGER
Credential: D.O.
Phone: 305-512-4460