Provider Demographics
NPI:1679540488
Name:KABINOFF, GARY S (MD)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:S
Last Name:KABINOFF
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 1:665 SE CENTRAL PARKWAY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994
Mailing Address - Country:US
Mailing Address - Phone:772-419-5959
Mailing Address - Fax:772-419-3047
Practice Address - Street 1:665 SE CENTRAL PARKWAY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994
Practice Address - Country:US
Practice Address - Phone:772-419-5959
Practice Address - Fax:772-419-3047
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73342207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL41307OtherBCBS
G51967Medicare UPIN
FL41307AMedicare ID - Type Unspecified