Provider Demographics
NPI:1407921968
Name:TRIBIT, KENNETH I (PT)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:I
Last Name:TRIBIT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4964 FRUITVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-2261
Mailing Address - Country:US
Mailing Address - Phone:941-706-1230
Mailing Address - Fax:941-706-1173
Practice Address - Street 1:4964 FRUITVILLE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-2261
Practice Address - Country:US
Practice Address - Phone:941-706-1230
Practice Address - Fax:941-706-1173
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 19775225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist