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Individual

JUAN C ABANSES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3001 W DR MARTIN LUTHER KING JR BLVD, EM DEPT, TAMPA, FL 33607-6307
(813) 870-4000
(386) 274-7801
Mailing address
PO BOX 9790, DAYTONA BEACH, FL 32120-9790
(386) 274-7800
(386) 274-7801

Taxonomy

Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
ME114914
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
117409500
FL
01
14P1R
BCBS
FL
01
GX151Z
MEDICARE PTAN
FL
Enumeration date
09/15/2005
Last updated
07/12/2023
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