Provider Demographics
NPI:1871922260
Name:SCHERBEKOW, ABRAM
Entity type:Individual
Prefix:
First Name:ABRAM
Middle Name:
Last Name:SCHERBEKOW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3496 RIVERHILL DR
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-6830
Mailing Address - Country:US
Mailing Address - Phone:850-994-6967
Mailing Address - Fax:
Practice Address - Street 1:3496 RIVERHILL DR
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-6830
Practice Address - Country:US
Practice Address - Phone:850-994-6967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBC1250510171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCBC1250510OtherCONTRACTOR