Healthcare Provider Details

I. General information

NPI: 1093995136
Provider Name (Legal Business Name): ADIB ADNAN ABLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2007
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1295 NW 14TH TERR
MIAMI FL
33125-1610
US

IV. Provider business mailing address

1475 NW 12TH AVE
MIAMI FL
33136-1002
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-6946
  • Fax:
Mailing address:
  • Phone: 305-243-2233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberME163108
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: