Provider Demographics
NPI:1568256725
Name:IDRIS-AGBABIAKA, ABDULLAAH (MD)
Entity type:Individual
Prefix:
First Name:ABDULLAAH
Middle Name:
Last Name:IDRIS-AGBABIAKA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LOT 1258, APARTMENT A
Mailing Address - Street 2:BLOCK EE, ECCLES
Mailing Address - City:EAST BANK DEMERARA
Mailing Address - State:GEORGETOWN
Mailing Address - Zip Code:413741
Mailing Address - Country:GY
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1611 NW 12 AVENUE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-335-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program