Provider Demographics
NPI:1609803709
Name:ABITBOL, CAROLYN L (MD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:L
Last Name:ABITBOL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1601 NW 12TH AVE
Mailing Address - Street 2:BOX 016960 M851
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33101-6960
Mailing Address - Country:US
Mailing Address - Phone:305-243-4029
Mailing Address - Fax:305-243-8470
Practice Address - Street 1:1601 NW 12TH AVE
Practice Address - Street 2:BOX 016960 M851
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33101-6960
Practice Address - Country:US
Practice Address - Phone:305-243-4029
Practice Address - Fax:305-243-8470
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2011-11-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME416192080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0680265-00Medicaid
FL0680265-00Medicaid
FLB13184Medicare UPIN