Provider Demographics
NPI:1952777815
Name:THALIA MARIE ABRAHAO, PA
Entity Type:Organization
Organization Name:THALIA MARIE ABRAHAO, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THALIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ABRAHAO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:646-734-6158
Mailing Address - Street 1:700 BILTMORE WAY
Mailing Address - Street 2:APT 705
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-7555
Mailing Address - Country:US
Mailing Address - Phone:646-734-6158
Mailing Address - Fax:
Practice Address - Street 1:700 BILTMORE WAY
Practice Address - Street 2:APT 705
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-7555
Practice Address - Country:US
Practice Address - Phone:646-734-6158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN207641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty