Provider Demographics
NPI:1831898113
Name:ABELLA PRIME LLC
Entity type:Organization
Organization Name:ABELLA PRIME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:EXPEDITO
Authorized Official - Last Name:ABELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-221-6161
Mailing Address - Street 1:8200 SW 117TH AVE STE 414
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4828
Mailing Address - Country:US
Mailing Address - Phone:305-221-6161
Mailing Address - Fax:305-559-2259
Practice Address - Street 1:8200 SW 117TH AVE STE 414
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4828
Practice Address - Country:US
Practice Address - Phone:305-221-6161
Practice Address - Fax:305-559-2259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty