Provider Demographics
NPI:1235432303
Name:ABBAY, ANARA KAYSER (MD)
Entity Type:Individual
Prefix:
First Name:ANARA
Middle Name:KAYSER
Last Name:ABBAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANAR
Other - Middle Name:MEYRANBEKOVNA
Other - Last Name:YERALIYEVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2338 IMMOKALEE RD
Mailing Address - Street 2:#186
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1445
Mailing Address - Country:US
Mailing Address - Phone:239-624-4053
Mailing Address - Fax:239-330-2933
Practice Address - Street 1:11190 HEALTH PARK BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-5729
Practice Address - Country:US
Practice Address - Phone:239-624-4053
Practice Address - Fax:239-330-2933
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-13
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME120937208M00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013392400Medicaid