Provider Demographics
NPI:1417919242
Name:ABREBAYA, ALBERTO (DPM)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:
Last Name:ABREBAYA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2574 NE 206TH TER
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1347
Mailing Address - Country:US
Mailing Address - Phone:305-266-9100
Mailing Address - Fax:305-648-0525
Practice Address - Street 1:600 NW 35TH AVE STE 100B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125
Practice Address - Country:US
Practice Address - Phone:305-266-9100
Practice Address - Fax:305-648-0525
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2370213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390158100Medicaid
FL390158100Medicaid
FLU-34577Medicare UPIN