Provider Demographics
NPI:1588388409
Name:ABRAHAM, JORELIS D
Entity type:Individual
Prefix:
First Name:JORELIS
Middle Name:D
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 VIOLET DELL
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-4972
Mailing Address - Country:US
Mailing Address - Phone:646-267-4193
Mailing Address - Fax:
Practice Address - Street 1:470 VIOLET DELL
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-4972
Practice Address - Country:US
Practice Address - Phone:646-267-4193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator