Provider Demographics
NPI:1922013754
Name:AMERICAN PHYSICIANS FOUNDATION CORPORATION
Entity Type:Organization
Organization Name:AMERICAN PHYSICIANS FOUNDATION CORPORATION
Other - Org Name:DIGESTIVE DISEASE FOUNDATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBASSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-388-8686
Mailing Address - Street 1:2151 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4416
Mailing Address - Country:US
Mailing Address - Phone:904-388-8686
Mailing Address - Fax:904-388-4445
Practice Address - Street 1:2151 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4416
Practice Address - Country:US
Practice Address - Phone:904-388-8686
Practice Address - Fax:904-388-4445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269791200Medicaid
FL269791200Medicaid