Provider Demographics
NPI:1831183938
Name:ABBASSI, ABDI (MD)
Entity type:Individual
Prefix:DR
First Name:ABDI
Middle Name:
Last Name:ABBASSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ABDOLREZA
Other - Middle Name:
Other - Last Name:ABBASSI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2 SHIRCLIFF WAY STE 435
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 SHIRCLIFF WAY STE 435
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204
Practice Address - Country:US
Practice Address - Phone:904-388-8686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0070964207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology