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NPI Code Detail

MEDICARE: DR. JOHN L. ABT DO, FACEP, FACFE

MEDICARE:  DR. JOHN L. ABT  DO, FACEP, FACFE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianOS6300FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CALL PROVIDEROTHERFLTRICARE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31184693400OTHERFLNATIONAL PROV IDENTIFIER
480669OTHERFLBLUE CROSS/BLUE SHIELD
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184693400
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN L. ABT DO, FACEP, FACFE
Provider Business Mailing Address
First Line : 9604 SOUTHERN PINES COURT
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33328-6909
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9604 SOUTHERN PINES COURT
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33328-6909
Country : US
Telephone Number : 954-423-6778
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 01/18/2012

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Directions to “ DR. JOHN L. ABT DO, FACEP, FACFE” Practice Location

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