=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790779767
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT D. SADATY M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/07/2005
-----------------------------------------------------
Last Update Date | 01/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14305 COLLIER BLVD
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34119-9589
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-270-3114
-----------------------------------------------------
Fax | 423-295-9320
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 112559
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34108-0143
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-270-3114
-----------------------------------------------------
Fax | 423-295-9320
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | ME84968
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------