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General NPI Number Information
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NPI Number | 1326752551
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Entity Type | Organization
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Legal Business Name | ABBY PEDIATRIC CARE LLC
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Dates
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Enumeration Date | 01/11/2023
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 31 BARKLEY CIR STE 2A
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City | FORT MYERS
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State | FL
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Zip | 33907-7628
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Country | US
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Telephone | 786-773-7851
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Fax |
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Provider Business Mailing Address
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Address Line | 1052 NW 134TH PL
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City | MIAMI
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State | FL
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Zip | 33182-2280
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Country | US
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Telephone | 786-773-7851
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DAYLI TAILLACQ BLANCO
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Credential |
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Telephone | 786-773-7851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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