Omar L Abadie, ATC,LAT
Individual provider Active NPI Athletic Trainer · Brandon, FL
NPI 1669994661 · NPPES record last updated Aug 15, 2017
Key facts
- NPI
- 1669994661
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- AL3703 (FL)
- Practice address
- 305 E Brandon Blvd
Brandon, FL 33511-5222 - Phone
- (813) 657-8448
- NPI assigned
- Jul 11, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL3703 | FL | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL3703 | FL | Yes |
Addresses
Primary practice location
305 E Brandon Blvd
Brandon, FL 33511-5222
Mailing address
13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925
Phone (813) 657-8448
Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.