MEDICARE: NORMAN S ABBOTT JR. 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	207RC0000X	Cardiovascular Disease Physician	ME0049317	FL

General Provider Information

NPI Number	:	1679582142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORMAN S ABBOTT JR. M.D.

Provider Business Mailing Address
First Line	:	4705 ALT 19 STE B
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-1424
Country	:	US
Telephone Number	:	727-935-6477
Fax Number	:	727-935-6478

Provider Business Practice Location Address
First Line	:	4705 ALT 19 STE B
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-1424
Country	:	US
Telephone Number	:	727-935-6477
Fax Number	:	727-935-6478

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	11/09/2018

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