MEDICARE: ABDO RAYMOND ASMAR M.D.

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
1	207RN0300X	Nephrology Physician	ME109500	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205869658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABDO RAYMOND ASMAR M.D.

Provider Business Mailing Address
First Line	:	3400 QUADRANGLE BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32817-1492
Country	:	US
Telephone Number	:	407-266-3627
Fax Number	:	407-882-4799

Provider Business Practice Location Address
First Line	:	9975 TAVISTOCK LAKES BLVD STE 160
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-7665
Country	:	US
Telephone Number	:	407-266-3627
Fax Number	:	407-882-4799

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	04/17/2019

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