Individual
MARIO ALBERTO IRAHETA ABREGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1714 N MAIN ST, JACKSONVILLE, FL 32206-4404
(904) 354-6868
(904) 358-3067
Mailing address
900 S PINE ISLAND RD STE 800, PLANTATION, FL 33324-3923
(904) 354-6868
(904) 358-3067
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME147054
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108158500
—
FL
Enumeration date
08/22/2011
Last updated
09/08/2021
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