Provider Demographics
NPI:1790779767
Name:SADATY, ROBERT D (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:SADATY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1845 VETERANS PARK DR STE 210
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0493
Mailing Address - Country:US
Mailing Address - Phone:239-624-0530
Mailing Address - Fax:239-624-0541
Practice Address - Street 1:9400 FOUNTAIN MEDICAL COURT
Practice Address - Street 2:SUITE B100
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135
Practice Address - Country:US
Practice Address - Phone:239-494-6244
Practice Address - Fax:239-992-4121
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2018-08-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME84968207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264718400Medicaid
FL202752811OtherTAX ID
FL51499OtherBCBS
FLH02721Medicare UPIN
FL264718400Medicaid