Provider Demographics
NPI:1770911216
Name:GEORGE T ABERNATHY MD PA
Entity type:Organization
Organization Name:GEORGE T ABERNATHY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:T
Authorized Official - Last Name:ABERNATHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-488-7333
Mailing Address - Street 1:395 COMMERCIAL CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-1649
Mailing Address - Country:US
Mailing Address - Phone:941-488-7333
Mailing Address - Fax:941-488-0847
Practice Address - Street 1:395 COMMERCIAL CT
Practice Address - Street 2:SUITE B
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1649
Practice Address - Country:US
Practice Address - Phone:941-488-7333
Practice Address - Fax:941-488-0847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-18
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME24925207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty