Provider Demographics
NPI:1679589188
Name:ABBASSI, TONY (MD)
Entity Type:Individual
Prefix:MR
First Name:TONY
Middle Name:
Last Name:ABBASSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:ABBASSI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:760 NW 62ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-4332
Mailing Address - Country:US
Mailing Address - Phone:305-325-9433
Mailing Address - Fax:
Practice Address - Street 1:760 NW 62ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-4332
Practice Address - Country:US
Practice Address - Phone:305-325-9433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75426207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G99359Medicare UPIN
44972Medicare ID - Type Unspecified