Provider Demographics
NPI:1932471505
Name:ABRAHAO, PAULA (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:
Last Name:ABRAHAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-434-8121
Mailing Address - Fax:321-434-8089
Practice Address - Street 1:820 PALM BAY RD NE
Practice Address - Street 2:SUITE 110
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-6351
Practice Address - Country:US
Practice Address - Phone:321-409-8140
Practice Address - Fax:321-409-5745
Is Sole Proprietor?:No
Enumeration Date:2012-01-30
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME112615207R00000X, 208M00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006532100Medicaid
FLGM257YOtherMEDICARE - FL