Provider Demographics
NPI:1104002229
Name:ABELLERA, ELIGIO QUIROS (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIGIO
Middle Name:QUIROS
Last Name:ABELLERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 STRATFORD CT
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30350-4155
Mailing Address - Country:US
Mailing Address - Phone:678-395-3422
Mailing Address - Fax:
Practice Address - Street 1:827 STRATFORD CT
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30350-4155
Practice Address - Country:US
Practice Address - Phone:678-395-3422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA16008172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker