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NPI Code Detail

MEDICARE: HEATHER KOCH

MEDICARE: HEATHER KOCH
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
1367H00000XAnesthesiologist Assistant

Other Identifiers

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

General Provider Information

NPI Number : 1316432537
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER KOCH
Provider Business Mailing Address
First Line : 8282 CANOPY TER
Second Line :
City : PARKLAND
State : FL
Zip : 33076-4493
Country : US
Telephone Number : 704-578-1094
Fax Number :
Provider Business Practice Location Address
First Line : 57 EXECUTIVE PARK S STE 300
Second Line :
City : ATLANTA
State : GA
Zip : 30329-2287
Country : US
Telephone Number : 404-727-5910
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2018
Last Update Date : 11/12/2025

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Directions to “ HEATHER KOCH ” Practice Location

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