Provider Demographics
NPI:1386375939
Name:ABRAHANTE, LUIS ANGEL (DMD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ANGEL
Last Name:ABRAHANTE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:LUIS
Other - Middle Name:
Other - Last Name:ABRAHANTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:6878 SW 35TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3722
Mailing Address - Country:US
Mailing Address - Phone:786-234-6072
Mailing Address - Fax:
Practice Address - Street 1:122 7TH AVE NE STE A
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-9121
Practice Address - Country:US
Practice Address - Phone:205-663-6545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL270561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice