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Individual

DR. JOHN L. ABT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO, FACEP, FACFE

Contact information

Practice address
9604 SOUTHERN PINES COURT, FT LAUDERDALE, FL 33328-6909
(954) 423-6778
Mailing address
9604 SOUTHERN PINES COURT, FT LAUDERDALE, FL 33328-6909

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS6300
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1184693400
NATIONAL PROV IDENTIFIER
FL
05
3707024-00
FL
01
80669
BLUE CROSS/BLUE SHIELD
FL
01
CALL PROVIDER
TRICARE
FL
Enumeration date
03/17/2006
Last updated
01/18/2012
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