Provider Demographics
NPI:1316030406
Name:STEINBERG, KENNETH I (DO)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:I
Last Name:STEINBERG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 S OREGON AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2542
Mailing Address - Country:US
Mailing Address - Phone:646-326-7868
Mailing Address - Fax:
Practice Address - Street 1:603 7TH ST S STE 360
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4732
Practice Address - Country:US
Practice Address - Phone:727-553-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2008-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219077207P00000X
FLOS10017207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01167OtherBLUE CROSS
FLAE707YMedicare PIN
NY0068DIMedicare PIN
H43432Medicare UPIN
P00444233Medicare PIN