Basic Information
Provider Information
NPI: 1881838340
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KABA
FirstName: DRAHMANE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
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OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5365 W ATLANTIC AVE
Address2: STE 504
City: DELRAY BEACH
State: FL
PostalCode: 334848194
CountryCode: US
TelephoneNumber: 5612419300
FaxNumber: 5612419339
Practice Location
Address1: 1693 LEE RD STE B
Address2:  
City: WINTER PARK
State: FL
PostalCode: 327892260
CountryCode: US
TelephoneNumber: 4076225766
FaxNumber: 4076225767
Other Information
ProviderEnumerationDate: 04/28/2009
LastUpdateDate: 01/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2081P2900XME116317FLN Allopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
208VP0000XME116317FLN Allopathic & Osteopathic PhysiciansPain MedicinePain Medicine
208VP0014XME116317FLY Allopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine

No ID Information.


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