Provider Demographics
NPI:1629218052
Name:PEDRO M ABRANTES DPM PA
Entity type:Organization
Organization Name:PEDRO M ABRANTES DPM PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:M
Authorized Official - Last Name:ABRANTES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-598-1114
Mailing Address - Street 1:7190 GALLOWAY ROAD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173
Mailing Address - Country:US
Mailing Address - Phone:305-598-1114
Mailing Address - Fax:305-598-1113
Practice Address - Street 1:7190 GALLOWAY ROAD
Practice Address - Street 2:SUITE 205
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173
Practice Address - Country:US
Practice Address - Phone:305-598-1114
Practice Address - Fax:305-598-1113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3309213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBH972OtherMEDICARE PTAN