Provider Demographics
NPI:1205800067
Name:ABRAMOWITZ, DORAIDA LEON (DMD)
Entity type:Individual
Prefix:DR
First Name:DORAIDA
Middle Name:LEON
Last Name:ABRAMOWITZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:250 3RD STREET NW
Mailing Address - Street 2:203
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881
Mailing Address - Country:US
Mailing Address - Phone:877-647-6673
Mailing Address - Fax:877-647-6673
Practice Address - Street 1:250 3RD STREET NW
Practice Address - Street 2:203
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881
Practice Address - Country:US
Practice Address - Phone:877-647-6673
Practice Address - Fax:877-647-6673
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN172021223D0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
No1223D0001XDental ProvidersDentistDental Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL076051000Medicaid