Provider Demographics
NPI:1992017958
Name:ABRAHAM TOTAH, M.D., P.A.
Entity Type:Organization
Organization Name:ABRAHAM TOTAH, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TOTAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-442-7338
Mailing Address - Street 1:611 S FORT HARRISON AVE STE 236
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-5301
Mailing Address - Country:US
Mailing Address - Phone:727-442-7338
Mailing Address - Fax:727-442-7068
Practice Address - Street 1:300 PINELLAS ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756
Practice Address - Country:US
Practice Address - Phone:727-442-7338
Practice Address - Fax:727-442-7068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-07
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81015261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH38202Medicare UPIN