Provider Demographics
NPI:1467421735
Name:ABRAHAM, JAMES C (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:371 CHANNELSIDE WALK WAY
Mailing Address - Street 2:UNIT 1103
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-6766
Mailing Address - Country:US
Mailing Address - Phone:813-228-7846
Mailing Address - Fax:813-218-9015
Practice Address - Street 1:371 CHANNELSIDE WALK WAY
Practice Address - Street 2:UNIT 1103
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-6766
Practice Address - Country:US
Practice Address - Phone:813-228-7846
Practice Address - Fax:813-218-9015
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME94672207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4486236OtherCIGNA
FL274616600Medicaid
FLP00423537OtherRAILROAD PROVIDER NUMBER
FL35121OtherBCBS
FL274616600Medicaid
FL35121AMedicare PIN