Basic Information
| Provider Information | |||||||||
| NPI: | 1215956115 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABBENSETTS | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | MAXWELL KOFI | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2800 E COMMERCIAL BLVD STE 102 | ||||||||
| Address2: | |||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333084202 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1600 S ANDREWS AVE | ||||||||
| Address2: | |||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333162510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543554400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2006 | ||||||||
| LastUpdateDate: | 07/22/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 215908 | MA | N | Allopathic & Osteopathic Physicians | Surgery | 174400000X | ME125710 | FL | N | Other Service Providers | Specialist | 2086S0102X | 215908 | MA | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0127X | ME125710 | FL | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 208600000X | ME125710 | FL | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.