Provider Demographics
NPI:1770937955
Name:ALFONSO REMIGIO, ABRAHAM (MD)
Entity type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:
Last Name:ALFONSO REMIGIO
Suffix:
Gender:M
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:PO BOX 15543
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33318-5543
Mailing Address - Country:US
Mailing Address - Phone:954-408-4655
Mailing Address - Fax:954-408-4656
Practice Address - Street 1:7540 NW 5TH ST STE 5
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1615
Practice Address - Country:US
Practice Address - Phone:954-408-4655
Practice Address - Fax:954-408-4656
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME137116207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine