Abraham I Awwad DO, LLC
Organization Active NPI Nephrology Physician · St Petersburg, FL
NPI 1801985494 · NPPES record last updated Mar 6, 2014
Key facts
- NPI
- 1801985494
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- OS 7025 (FL)
- Legal business name
- ABRAHAM I AWWAD DO, LLC
- Practice address
- 3622 Central Ave
St Petersburg, FL 33711-1345 - Phone
- (727) 322-0245
- Fax
- (727) 323-0994
- NPI assigned
- Oct 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Abraham I Awwad, DO
- Title
- President
- Phone
- (727) 322-0245
Practitioners 1
-
Abraham I Awwad, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061101000118 | FL | Part B Supplier - Clinic/Group Practice | 1951308147 |
Receives reassigned benefits from 1 practitioner Practice locations: St Petersburg, FL |
National Provider Directory
Locations
5633 1st Ave S
St Petersburg, FL 33707
Phone (727) 322-0245
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician |
207RN0300X | OS 7025 | FL | Yes |
Addresses
Primary practice location
3622 Central Ave
St Petersburg, FL 33711-1345
Mailing address
3622 Central Ave
St Petersburg, FL 33711-1345
Phone (727) 322-0245
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 254983200 | Medicaid | FL |
Other names
- N/A
Other providers in St Petersburg, FL
- Ibrahim Abiola
- Able Body Companion, LLC
- Mariam Aboulela
- Above Board Healthcare LLC
- Above Board Healthcare LLC
- David Abraham
- Nancy M Abrahamsen
- Jason Craig Abrahamson
- Sarah Abramovitz
- Harvey B Abrams
All providers in St Petersburg, FL · Nephrology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.