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General NPI Number Information
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NPI Number | 1386606325
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Entity Type | Individual
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Provider Name | GERALD M ABRAHAM MD
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Gender | Male
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 12/10/2018
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Provider Practice Location Address
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Address Line | 11983 TAMIAMI TRL N STE 120
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City | NAPLES
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State | FL
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Zip | 34110-1601
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Country | US
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Telephone | 239-334-1478
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Fax | 772-673-4623
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Provider Business Mailing Address
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Address Line | PO BOX 881832
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34988-1832
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Country | US
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Telephone | 772-678-1147
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Fax | 772-673-4623
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | ME38969
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | ME0038969
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME0038969
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License Number State | FL
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