Provider Demographics
NPI:1003805664
Name:SABATINO, KENNETH CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:CHRISTOPHER
Last Name:SABATINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 PINELLAS STREET
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3356
Mailing Address - Country:US
Mailing Address - Phone:727-445-1911
Mailing Address - Fax:727-445-1986
Practice Address - Street 1:1840 MEASE DR STE 202
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-6604
Practice Address - Country:US
Practice Address - Phone:727-725-6246
Practice Address - Fax:727-726-5865
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83659207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262818000Medicaid
FL262818000Medicaid
06810ZMedicare ID - Type Unspecified