MEDICARE: DR. CLARISSA ROSE ABRANTES MD

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	207R00000X	Internal Medicine Physician	ME99375	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	17923	OTHER		BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578773917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLARISSA ROSE ABRANTES MD

Provider Business Mailing Address
First Line	:	871 COUNTY ROAD 466
Second Line	:	SUITE 200
City	:	LADY LAKE
State	:	FL
Zip	:	32519-4205
Country	:	US
Telephone Number	:	352-350-5130
Fax Number	:	352-350-1684

Provider Business Practice Location Address
First Line	:	871 COUNTY ROAD 466
Second Line	:	SUITE 200
City	:	LADY LAKE
State	:	FL
Zip	:	32159-4205
Country	:	US
Telephone Number	:	352-350-5130
Fax Number	:	352-350-1684

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

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	02/24/2023

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