Provider Demographics
NPI:1700246972
Name:ABREU, ANTONIO JR (DNP, APRN)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:
Last Name:ABREU
Suffix:JR
Gender:M
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 WAYMAN CIR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33413-2307
Mailing Address - Country:US
Mailing Address - Phone:561-567-9499
Mailing Address - Fax:561-463-8496
Practice Address - Street 1:2540 W EXECUTIVE CENTER CIRCLE
Practice Address - Street 2:SUITE 100 DPT#25031
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2307
Practice Address - Country:US
Practice Address - Phone:561-257-0996
Practice Address - Fax:561-463-8496
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-02
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2831363LF0000X
COC-APN.0001708-C-NP363LF0000X
FL9346616363LF0000X
NV814181363L00000X
IDCNP63808363LF0000X
NM57650363LF0000X
NH082291-23363LF0000X
WAAP61035326363LF0000X
WY45491363LF0000X
AK158168363LF0000X
NE113107363LF0000X
MN7346363LF0000X
MDAC003115363LF0000X
OR202000545NP-PP363LF0000X
MT158013363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101174500Medicaid