Kenneth Abbott
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Gainesville, FL
NPI 1013596527 · NPPES record last updated Jul 4, 2025
Key facts
- NPI
- 1013596527
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 1147 NW 64TH Ter
Gainesville, FL 32605-4218 - Phone
- (352) 333-5152
- NPI assigned
- Apr 3, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250709002428 | FL | Order and Referring Only - Family Practice |
0840696316 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
1147 NW 64TH Ter
Gainesville, FL 32605-4218
Mailing address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Other providers in Gainesville, FL
- Rene Abayan-Rosenstein
- Areeb Abbasi
- Zunnaira Abbasi
- Kaitria Brielle Abbatematteo
- Patricia L Abbitt
- Tony Lee Abbott
- Maria Jose Abboud
- Abc Wellness, LLC
- Sherine Abdalla
- Naglaa Zidan Elsayed Abdel-Al
All providers in Gainesville, FL · Student in an Organized Health Care Education/Training Program in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.