Provider Demographics
NPI:1023062999
Name:ABOSCH, AVIVA (MD)
Entity type:Individual
Prefix:
First Name:AVIVA
Middle Name:
Last Name:ABOSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8950 N KENDALL DR STE 405W
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2132
Mailing Address - Country:US
Mailing Address - Phone:786-972-6170
Mailing Address - Fax:
Practice Address - Street 1:8950 N KENDALL DR STE 405W
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2132
Practice Address - Country:US
Practice Address - Phone:786-972-6170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME176471207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0598151Medicaid
MN321967400Medicaid
B692OtherCHAMPUS/TRICARE
HP57431OtherHEALTHPARTNERS
IA0598151Medicaid
06-00004OtherMEDICA PRIMARY
650T0ABOtherBCBS
06-00192OtherMEDICA CHOICE
WI34806200Medicaid
IA0598151Medicaid
H67566Medicare UPIN
MN321967400Medicaid