Provider Demographics
NPI:1093746521
Name:ABELLO, ANA LILA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:LILA
Last Name:ABELLO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:LILA
Other - Middle Name:
Other - Last Name:ABELLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:940 NE 62ND ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334-4110
Mailing Address - Country:US
Mailing Address - Phone:954-415-7910
Mailing Address - Fax:954-771-9267
Practice Address - Street 1:940 NE 62ND ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334-4110
Practice Address - Country:US
Practice Address - Phone:954-415-7910
Practice Address - Fax:954-771-9267
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4351103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73699Medicare ID - Type Unspecified