Provider Demographics
NPI:1629284575
Name:ABBO, ELI (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELI
Middle Name:
Last Name:ABBO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19940 NE 22ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1804
Mailing Address - Country:US
Mailing Address - Phone:954-594-0595
Mailing Address - Fax:305-705-1372
Practice Address - Street 1:3031 NE 163RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4462
Practice Address - Country:US
Practice Address - Phone:305-945-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16930122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist