Provider Demographics
NPI:1205895653
Name:ABELLA, ELEANOR CHOY (MD)
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:CHOY
Last Name:ABELLA
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 1:395 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAKE BUTLER
Mailing Address - State:FL
Mailing Address - Zip Code:32054-1642
Mailing Address - Country:US
Mailing Address - Phone:386-496-3154
Mailing Address - Fax:386-243-6500
Practice Address - Street 1:395 W MAIN ST
Practice Address - Street 2:NEW RIVER HEALTH @UNION COUNTY
Practice Address - City:LAKE BUTLER
Practice Address - State:FL
Practice Address - Zip Code:32054-1642
Practice Address - Country:US
Practice Address - Phone:386-496-3154
Practice Address - Fax:386-243-6500
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79371208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266417OtherAVMED
FL257880800Medicaid
FL49388OtherBCBS
FL266417OtherAVMED
FL257880800Medicaid