MEDICARE: DAVID KOS DO

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	2085R0202X	Diagnostic Radiology Physician	OS8920	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00434656	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	93835	OTHER	FL	BCBS FL
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295739522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID KOS DO

Provider Business Mailing Address
First Line	:	PO BOX 150505
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32715-0505
Country	:	US
Telephone Number	:	407-767-0433
Fax Number	:	407-767-0608

Provider Business Practice Location Address
First Line	:	601 E ROLLINS ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-1248
Country	:	US
Telephone Number	:	407-303-1944
Fax Number	:

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	03/13/2008

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Directions to “ DAVID KOS DO” Practice Location

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