Provider Demographics
NPI:1134108996
Name:ABRAHAM, VARKEY (PA)
Entity Type:Individual
Prefix:
First Name:VARKEY
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11118 STONEWOOD FOREST TRL
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33473-4884
Mailing Address - Country:US
Mailing Address - Phone:954-328-4495
Mailing Address - Fax:561-736-3733
Practice Address - Street 1:21644 STATE ROAD 7
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1842
Practice Address - Country:US
Practice Address - Phone:561-488-8000
Practice Address - Fax:904-346-0113
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA0003670363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS84090Medicare UPIN
FLE2756RMedicare ID - Type Unspecified