Provider Demographics
NPI:1912936733
Name:TOTAH, ABRAHAM R (MD)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:R
Last Name:TOTAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:611 S FORT HARRISON AVE STE 236
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-5301
Mailing Address - Country:US
Mailing Address - Phone:727-442-7338
Mailing Address - Fax:727-442-7068
Practice Address - Street 1:1399 HAMLET AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3331
Practice Address - Country:US
Practice Address - Phone:727-442-7338
Practice Address - Fax:727-442-7068
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME810152084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260878200Medicaid
FL260878200Medicaid
FL00001742Medicare ID - Type Unspecified