| Abraham Infectious Disease Associates 2 Llc | |
|
2927 Kerry Forest Pkwy Tallahassee FL 32309-7815 | |
| (850) 329-2872 | |
| (850) 329-2882 |
| Full Name | Abraham Infectious Disease Associates 2 Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2927 Kerry Forest Pkwy, Tallahassee, Florida |
| Authorized Official Name and Position | Gizatchew Ketsela (OWNER) |
| Authorized Official Contact | 8509182405850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abraham Infectious Disease Associates 2 Llc 2910 Kerry Forest Pkwy # D4-369 Tallahassee FL 32309-6892 Ph: (850) 329-2872 | Abraham Infectious Disease Associates 2 Llc 2927 Kerry Forest Pkwy Tallahassee FL 32309-7815 Ph: (850) 329-2872 |
| NPI Number | 1376094615 |
|---|---|
| Provider Enumeration Date | 10/21/2016 |
| Last Update Date | 11/07/2016 |
| Medicare PECOS PAC ID | 5496036303 |
|---|---|
| Medicare Enrollment ID | O20170109002521 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376094615 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | ME99953 (Florida) | Primary |
| Provider Name | Gizatchew Ketsela |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1023166832 PECOS PAC ID: 8527011550 Enrollment ID: I20100309000685 |
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