Individual
DR. VERA UTAGAH ABAABA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
820 PRUDENTIAL DR STE 304, CREDENTIALING DEPARTMENT, JACKSONVILLE, FL 32207-8205
(904) 202-3860
(904) 202-3846
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-2092
(904) 376-4075
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME120882
FL
208M00000X
Hospitalist Physician
Primary
ME120882
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012801500
—
FL
01
—
P10366899
RR MEDICARE
FL
Enumeration date
05/12/2011
Last updated
08/13/2024
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