Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | ME144449 | FL |
NPI | 1194143115 |
---|---|
Provider Name | Dennrik Abrahan |
First Address | St Petersburg, FL 33701-1547 |
Second Address | Tampa, FL 33606-3475 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2014 |
Last Update Date | 27/03/2020 |