Provider Demographics
NPI:1962475129
Name:ABRAMS, LORI A (DO)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 S TAMIAMI TRL
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5101
Mailing Address - Country:US
Mailing Address - Phone:941-953-5340
Mailing Address - Fax:941-955-8568
Practice Address - Street 1:3131 S TAMIAMI TRL
Practice Address - Street 2:SUITE 202
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5101
Practice Address - Country:US
Practice Address - Phone:941-953-5340
Practice Address - Fax:941-955-8568
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 7418207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL239574OtherAVMED
FL57586OtherBLUE SHIELD OF FLORIDA
FL7005077001OtherCIGNA
FL2002369OtherAETNA
FL7005077001OtherCIGNA
FLG64867Medicare UPIN