Individual
GERALD M ABRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11983 TAMIAMI TRL N STE 120, NAPLES, FL 34110-1601
(239) 334-1478
(772) 673-4623
Mailing address
PO BOX 881832, PORT SAINT LUCIE, FL 34988-1832
(772) 678-1147
(772) 673-4623
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME0038969
FL
208VP0000X
Pain Medicine Physician
ME38969
FL
208VP0014X
Interventional Pain Medicine Physician
ME0038969
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
CIGNA
—
01
—
027338
BEACON ( VALUE OPTIONS)
—
05
—
062913800
—
FL
01
—
092955000
MAGELLAN
—
01
—
09749
BC BS
FL
01
—
09749
AETNA
—
01
—
206235
HARMONY
—
01
—
260010362
RAILROAD MEDICARE
—
Enumeration date
04/05/2006
Last updated
12/10/2018
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