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:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3911 W WATERS AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-1950
Mailing Address - Country:US
Mailing Address - Phone:813-772-4563
Mailing Address - Fax:
Practice Address - Street 1:3911 W WATERS AVE STE 4
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1950
Practice Address - Country:US
Practice Address - Phone:813-772-4563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-16
Last Update Date:2025-08-15
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