MEDICARE: ROBERT J ABIUSI PA-C

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	363A00000X	Physician Assistant	PA9100979	FL
2	363AM0700X	Medical Physician Assistant	PA9100979	FL
3	363AS0400X	Surgical Physician Assistant	PA9100979	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

General Provider Information

NPI Number	:	1376525899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT J ABIUSI PA-C

Provider Business Mailing Address
First Line	:	1397 MEDICAL PARK BLVD
Second Line	:	SUITE 260
City	:	WELLINGTON
State	:	FL
Zip	:	33414-3186
Country	:	US
Telephone Number	:	561-739-2140
Fax Number	:	561-472-0467

Provider Business Practice Location Address
First Line	:	1397 MEDICAL PARK BLVD
Second Line	:	SUITE 260
City	:	WELLINGTON
State	:	FL
Zip	:	33414-6156
Country	:	US
Telephone Number	:	561-739-2140
Fax Number	:	561-472-0467

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

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	09/13/2011

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Directions to “ ROBERT J ABIUSI PA-C” Practice Location

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