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General NPI Number Information
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NPI Number | 1619188976
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Entity Type | Organization
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Legal Business Name | OMNIA SUMMA INC
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 1900 GLADES ROAD SUITE 299
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City | BOCA RATON
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State | FL
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Zip | 33431
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Country | US
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Telephone | 561-750-3201
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Fax | 561-750-5226
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Provider Business Mailing Address
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Address Line | PO BOX 970445
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City | BOCA RATON
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State | FL
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Zip | 33497
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Country | US
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Telephone | 561-750-3201
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Fax | 561-750-5226
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID ELIE ABISROR
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Credential | MD
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Telephone | 561-750-3201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME34112
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License Number State | FL
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