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General NPI Number Information
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NPI Number | 1114269933
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Entity Type | Organization
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Legal Business Name | PHYSICIAN'S AT HOME VISITING PROGRAM, INC.
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Dates
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Enumeration Date | 03/19/2013
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Last Update Date | 01/04/2017
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Provider Practice Location Address
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Address Line | 7085 SW 47TH ST
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City | MIAMI
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State | FL
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Zip | 33155-4652
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Country | US
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Telephone | 786-269-7939
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Fax |
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Provider Business Mailing Address
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Address Line | 7085 SW 47TH ST
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City | MIAMI
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State | FL
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Zip | 33155-4652
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Country | US
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Telephone | 786-269-7939
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SIMON C ABELSON
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Credential | MD
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Telephone | 786-269-7939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | ME93384
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License Number State | FL
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