Provider Demographics
NPI:1477155588
Name:ABRAMS, MENOCCA
Entity Type:Individual
Prefix:
First Name:MENOCCA
Middle Name:
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 JEFFERIS CT
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-5114
Mailing Address - Country:US
Mailing Address - Phone:407-803-1102
Mailing Address - Fax:
Practice Address - Street 1:600 JEFFERIS CT
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-5114
Practice Address - Country:US
Practice Address - Phone:407-803-1102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator