Provider Demographics
NPI:1508436882
Name:ABMAYOR LLC
Entity Type:Organization
Organization Name:ABMAYOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-528-1244
Mailing Address - Street 1:5881 ANISE DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-5143
Mailing Address - Country:US
Mailing Address - Phone:618-528-1244
Mailing Address - Fax:
Practice Address - Street 1:6400 EDGELAKE DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-8813
Practice Address - Country:US
Practice Address - Phone:941-921-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty