MEDICARE: DR. MATTHEW PAUL KOCHUBA 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	2086S0102X	Surgical Critical Care Physician	ME141452	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1316385727	OTHER	MD	GENERAL SURGERY
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316385727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW PAUL KOCHUBA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 44008
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32231-4008
Country	:	US
Telephone Number	:	904-383-1015
Fax Number	:	904-244-7454

Provider Business Practice Location Address
First Line	:	653 W 8TH ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-6511
Country	:	US
Telephone Number	:	904-383-1015
Fax Number	:	904-244-7454

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

Provider Enumeration Date	:	06/07/2013
Last Update Date	:	02/24/2026

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