Provider Demographics
NPI:1891144168
Name:ABALLI, NEMEGLESSIS
Entity Type:Individual
Prefix:
First Name:NEMEGLESSIS
Middle Name:
Last Name:ABALLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5470 W 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2531
Mailing Address - Country:US
Mailing Address - Phone:786-294-5226
Mailing Address - Fax:
Practice Address - Street 1:5470 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2531
Practice Address - Country:US
Practice Address - Phone:305-505-9055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician