Provider Demographics
NPI:1083751499
Name:KOZMA, ABRAHAM I (DC)
Entity Type:Individual
Prefix:MR
First Name:ABRAHAM
Middle Name:I
Last Name:KOZMA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 SAWYER ROAD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1272
Mailing Address - Country:US
Mailing Address - Phone:941-924-9892
Mailing Address - Fax:941-924-7283
Practice Address - Street 1:4010 SAWYER ROAD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1272
Practice Address - Country:US
Practice Address - Phone:941-924-9892
Practice Address - Fax:941-924-7283
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7843111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL53877OtherBCBS
FL53877OtherBCBS
FLE3921Medicare ID - Type Unspecified