Provider Demographics
NPI:1770540734
Name:ABISLAIMAN, RITA (MD)
Entity type:Individual
Prefix:MS
First Name:RITA
Middle Name:
Last Name:ABISLAIMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:RITA
Other - Middle Name:
Other - Last Name:ABISLAIMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD,PA
Mailing Address - Street 1:PO BOX 565939
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33256-5939
Mailing Address - Country:US
Mailing Address - Phone:305-326-1140
Mailing Address - Fax:305-326-1460
Practice Address - Street 1:1321 NW 14TH ST
Practice Address - Street 2:SUITE 503 B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1673
Practice Address - Country:US
Practice Address - Phone:305-326-1140
Practice Address - Fax:305-326-1460
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00721592084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21058AMedicare ID - Type UnspecifiedMEDICARE NO
FLG60227Medicare UPIN
FLK5442Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER