Provider Demographics
NPI:1760960108
Name:ABRAHAM ROSARIO, IREHM MARGARITA (SA-C)
Entity Type:Individual
Prefix:
First Name:IREHM
Middle Name:MARGARITA
Last Name:ABRAHAM ROSARIO
Suffix:
Gender:F
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3603 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33403-1633
Mailing Address - Country:US
Mailing Address - Phone:561-720-9398
Mailing Address - Fax:
Practice Address - Street 1:3603 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33403-1633
Practice Address - Country:US
Practice Address - Phone:561-720-9398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-28
Last Update Date:2018-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17-230246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant