MEDICARE: DR. VICTOR S KOO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	ME37667	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083665269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTOR S KOO M.D.

Provider Business Mailing Address
First Line	:	4415 WOODFIELD BLVD
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33434-5303
Country	:	US
Telephone Number	:	561-736-3888
Fax Number	:	561-732-1737

Provider Business Practice Location Address
First Line	:	2623 S SEACREST BLVD
Second Line	:	SUITE 216
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-7501
Country	:	US
Telephone Number	:	561-736-3888
Fax Number	:	561-732-1737

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2006
Last Update Date	:	01/13/2017

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Directions to “ DR. VICTOR S KOO M.D.” Practice Location

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