Healthcare Provider Details

I. General information

NPI: 1932559085
Provider Name (Legal Business Name): ABRAHAM ABDEMUR MD,CSA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 11/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SARNO RD SUITE 15
MELBOURNE FL
32935-4938
US

IV. Provider business mailing address

3100 W END AVE STE 800
NASHVILLE TN
37203-1378
US

V. Phone/Fax

Practice location:
  • Phone: 800-345-4565
  • Fax: 888-468-6511
Mailing address:
  • Phone: 615-345-5400
  • Fax: 888-468-6511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number15-571
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: