Provider Demographics
NPI:1568443984
Name:ABIS, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ABIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-6006
Mailing Address - Country:US
Mailing Address - Phone:561-659-0770
Mailing Address - Fax:561-802-3504
Practice Address - Street 1:2013 PONCE DE LEON AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-6019
Practice Address - Country:US
Practice Address - Phone:561-659-0770
Practice Address - Fax:561-802-3504
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 57181207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057828200Medicaid
FL14396OtherBLUE CROSS BLUE SHIELD
FL14396TMedicare PIN
220010834Medicare PIN
FL14396ZMedicare PIN
FL14396OtherBLUE CROSS BLUE SHIELD
F09585Medicare UPIN
FL14396UMedicare PIN