Provider Demographics
NPI:1295595668
Name:ABRAHAM, SAMUELA SAINT FLEUR
Entity type:Individual
Prefix:
First Name:SAMUELA
Middle Name:SAINT FLEUR
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 ELMHURST RD APT A
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-4514
Mailing Address - Country:US
Mailing Address - Phone:561-452-8055
Mailing Address - Fax:
Practice Address - Street 1:5050 ELMHURST RD APT A
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-4514
Practice Address - Country:US
Practice Address - Phone:561-452-8055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLVH235343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)