Healthcare Provider Details

I. General information

NPI: 1982252417
Provider Name (Legal Business Name): ABRAHAM ASHTON APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 N DIXIE HWY
POMPANO BEACH FL
33060-5621
US

IV. Provider business mailing address

1501 NE MIAMI GDN DR APT 242
MIAMI FL
33179-4859
US

V. Phone/Fax

Practice location:
  • Phone: 954-785-8285
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9394550
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11015652
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: