Healthcare Provider Details

I. General information

NPI: 1609040039
Provider Name (Legal Business Name): ALIA ABDULLA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1228 S PINE ISLAND RD STE 410
PLANTATION FL
33324-4583
US

IV. Provider business mailing address

PO BOX 198054
ATLANTA GA
30384-8054
US

V. Phone/Fax

Practice location:
  • Phone: 954-837-1490
  • Fax:
Mailing address:
  • Phone: 786-662-7980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberOS12956
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: