Provider Demographics
NPI:1144458977
Name:ABINALES, BENJAMIN JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:JOHN
Last Name:ABINALES
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 1:1522 75TH CIR NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4614
Mailing Address - Country:US
Mailing Address - Phone:727-526-4122
Mailing Address - Fax:
Practice Address - Street 1:7500 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-5410
Practice Address - Country:US
Practice Address - Phone:727-526-4122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125052231390200000X
FLME 106734207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL148EZOtherBCBS OF FLORIDA