Provider Demographics
NPI:1326092347
Name:SABADISH, JOSEPH JUDE (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JUDE
Last Name:SABADISH
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 1:1969 72ND AVENUE NE
Mailing Address - Street 2:
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702
Mailing Address - Country:US
Mailing Address - Phone:727-521-2843
Mailing Address - Fax:
Practice Address - Street 1:2 COLUMBIA DRIVE
Practice Address - Street 2:SUITE: A-327
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606
Practice Address - Country:US
Practice Address - Phone:813-844-4396
Practice Address - Fax:813-844-4972
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51326207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL04906VOtherGTBA MEDICARE REASSIGN
FL04906OtherBCBS
FLP00162827OtherMEDICARE RAILROAD
FL04906Medicare ID - Type UnspecifiedFL MEDICARE
FL04906VOtherGTBA MEDICARE REASSIGN