Healthcare Provider Details

I. General information

NPI: 1497702542
Provider Name (Legal Business Name): ADEL ABDALLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11253 S APOPKA VINELAND RD
ORLANDO FL
32836-6110
US

IV. Provider business mailing address

11253 S APOPKA VINELAND RD
ORLANDO FL
32836-6110
US

V. Phone/Fax

Practice location:
  • Phone: 407-745-1481
  • Fax:
Mailing address:
  • Phone: 877-879-3603
  • Fax: 800-410-4819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME81488
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number036-097141
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number234540
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberW1526
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD429782
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036-097141
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: