Provider Demographics
NPI:1801761135
Name:ABREU, LUIS A JR
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:A
Last Name:ABREU
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 VERONA PL
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33897-7463
Mailing Address - Country:US
Mailing Address - Phone:786-546-2253
Mailing Address - Fax:
Practice Address - Street 1:162 VERONA PL
Practice Address - Street 2:162 VERONA PL
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33897-7463
Practice Address - Country:US
Practice Address - Phone:786-546-2253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-07
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLA162-521-97-055-0343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)