Provider Demographics
NPI:1386829984
Name:TAHER, ABIDA (MD, PHD)
Entity Type:Individual
Prefix:
First Name:ABIDA
Middle Name:
Last Name:TAHER
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1573 COACHMAKERS LANE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-1703
Mailing Address - Country:US
Mailing Address - Phone:832-860-2812
Mailing Address - Fax:
Practice Address - Street 1:1573 COACHMAKERS LN
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1703
Practice Address - Country:US
Practice Address - Phone:832-860-2812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME105652207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020042900Medicaid