Provider Demographics
NPI:1619939113
Name:ABRAMSON, ISRAEL JACK (MD)
Entity Type:Individual
Prefix:DR
First Name:ISRAEL
Middle Name:JACK
Last Name:ABRAMSON
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 1:21110 BISCAYNE BLVD
Mailing Address - Street 2:#406
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1227
Mailing Address - Country:US
Mailing Address - Phone:305-935-4391
Mailing Address - Fax:305-935-9136
Practice Address - Street 1:21110 BISCAYNE BLVD
Practice Address - Street 2:#406
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1227
Practice Address - Country:US
Practice Address - Phone:305-935-4391
Practice Address - Fax:305-935-9136
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME575032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10817ZMedicare ID - Type Unspecified
FLE38733Medicare UPIN