Healthcare Provider Details

I. General information

NPI: 1932471505
Provider Name (Legal Business Name): PAULA ABRAHAO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2012
Last Update Date: 11/20/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 PALM BAY RD NE SUITE 110
PALM BAY FL
32905-6351
US

IV. Provider business mailing address

3300 S FISKE BLVD
ROCKLEDGE FL
32955-4306
US

V. Phone/Fax

Practice location:
  • Phone: 321-409-8140
  • Fax: 321-409-5745
Mailing address:
  • Phone: 321-434-8121
  • Fax: 321-434-8089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME112615
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME112615
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: