Provider Demographics
NPI:1942229844
Name:ABRAMS, JODY GOTTLIEB (MD)
Entity Type:Individual
Prefix:DR
First Name:JODY
Middle Name:GOTTLIEB
Last Name:ABRAMS
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 1:3400 BEE RIDGE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-7243
Mailing Address - Country:US
Mailing Address - Phone:941-921-5335
Mailing Address - Fax:941-921-1741
Practice Address - Street 1:3400 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-7243
Practice Address - Country:US
Practice Address - Phone:941-921-5335
Practice Address - Fax:941-921-1741
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME109729207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME109729OtherFL MEDICAL LICENCES
FLME109729OtherFL MEDICAL LICENCES
MIM92650008Medicare ID - Type UnspecifiedMEDICARE ID
TN3000464Medicare PIN