Provider Demographics
NPI:1790091965
Name:IRA JOEL ABRAMSON, M.D. PA
Entity Type:Organization
Organization Name:IRA JOEL ABRAMSON, M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:ABRAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-893-5725
Mailing Address - Street 1:12900 NE 17TH AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2058
Mailing Address - Country:US
Mailing Address - Phone:305-893-5725
Mailing Address - Fax:305-893-0002
Practice Address - Street 1:12900 NE 17TH AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2058
Practice Address - Country:US
Practice Address - Phone:305-893-5725
Practice Address - Fax:305-893-0002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0010870174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD52182Medicare UPIN