Provider Demographics
NPI:1619188976
Name:OMNIA SUMMA INC
Entity Type:Organization
Organization Name:OMNIA SUMMA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ELIE
Authorized Official - Last Name:ABISROR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-750-3201
Mailing Address - Street 1:PO BOX 970445
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33497
Mailing Address - Country:US
Mailing Address - Phone:561-750-3201
Mailing Address - Fax:561-750-5226
Practice Address - Street 1:1900 GLADES ROAD
Practice Address - Street 2:SUITE 299
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431
Practice Address - Country:US
Practice Address - Phone:561-750-3201
Practice Address - Fax:561-750-5226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME341122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty