Provider Demographics
NPI:1528124757
Name:ABINALES, PACITA TIONGSON (MD)
Entity type:Individual
Prefix:DR
First Name:PACITA
Middle Name:TIONGSON
Last Name:ABINALES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-5410
Mailing Address - Country:US
Mailing Address - Phone:727-526-4122
Mailing Address - Fax:727-525-1230
Practice Address - Street 1:7500 4TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-5410
Practice Address - Country:US
Practice Address - Phone:727-526-4122
Practice Address - Fax:727-525-1230
Is Sole Proprietor?:No
Enumeration Date:2006-12-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0027211208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL059064900Medicaid
081175OtherAVMED
208715OtherAMERIGROUP
FL52971OtherBLUE C ROSS BLUE SHIELD
020013776OtherRAILROAD MEDICARE
FL02682OtherPIN COUNTY SOCIAL SERVICE
FL02682OtherHEALTHEASE
FL52971OtherBLUE C ROSS BLUE SHIELD
FL52971Medicare PIN