Provider Demographics
NPI:1851353940
Name:ABRAHAMY, RAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RAN
Middle Name:
Last Name:ABRAHAMY
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 1:2234 COLONIAL BLVD
Mailing Address - Street 2:MANAGED CARE DEPT
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:7421 N UNIVERSITY DR
Practice Address - Street 2:SUITE 201
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2977
Practice Address - Country:US
Practice Address - Phone:954-722-9400
Practice Address - Fax:954-722-9409
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0034854208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL93716OtherBCBS OF FL
FLQMP000003940744OtherMOLINA
FL00266OtherWELLCARE MEDICARE
FL4077465OtherAETNA PROVIDER #
FLP00601890OtherRAILROAD MEDICARE
FLP0003129OtherFLORIDA HEALTHCARE PLUS
FL03830070Medicaid
FLD60561Medicare UPIN
FL93716Medicare PIN
FL93716WMedicare PIN