Healthcare Provider Details

I. General information

NPI: 1902720618
Provider Name (Legal Business Name): MEDICAL DIRECTOR SERVICES FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 W LUMSDEN RD FL 33511
BRANDON FL
33511-6280
US

IV. Provider business mailing address

4740 WHITE PLAINS RD
BRONX NY
10470-1120
US

V. Phone/Fax

Practice location:
  • Phone: 917-740-3853
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SHMUEL KOHN
Title or Position: MANAGER
Credential:
Phone: 917-740-3853