Basic Information
| Provider Information | |||||||||
| NPI: | 1528180981 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABELLON | ||||||||
| FirstName: | JUAN | ||||||||
| MiddleName: | ANTONIO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4200 SUN N LAKE BLVD | ||||||||
| Address2: | |||||||||
| City: | SEBRING | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338721986 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8634023405 | ||||||||
| FaxNumber: | 8634023468 | ||||||||
| Practice Location | |||||||||
| Address1: | 5900 S. JOHN YOUNG PKWY | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073986470 | ||||||||
| FaxNumber: | 4078946872 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2007 | ||||||||
| LastUpdateDate: | 03/23/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | ME# 0055474 | FL | Y | Allopathic & Osteopathic Physicians | Pediatrics | 208M00000X | ME#0055474 | FL | N | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 061351700 | 05 | FL | MEDICAID | 113857403 | 05 | FL | MEDICAID |