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General NPI Number Information
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NPI Number | 1700761020
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Entity Type | Individual
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Provider Name | ABIGAIL RUBEN BRACAMONTE
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Gender | Male
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 3100 SW 62ND AVE
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City | MIAMI
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State | FL
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Zip | 33155-3009
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Country | US
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Telephone | 305-669-7155
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Fax |
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Provider Business Mailing Address
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Address Line | 2186 W 60TH ST APT 20102
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City | HIALEAH
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State | FL
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Zip | 33016-7712
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Country | US
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Telephone | 786-417-1958
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Fax |
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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 | 208U00000X
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Taxonomy Name | Clinical Pharmacology Physician
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License Number | PS69234
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License Number State | FL
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