Healthcare Provider Details

I. General information

NPI: 1396495446
Provider Name (Legal Business Name): CONSTANTINE HOSH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14000 FIVAY RD
HUDSON FL
34667-7103
US

IV. Provider business mailing address

14000 FIVAY RD
HUDSON FL
34667-7103
US

V. Phone/Fax

Practice location:
  • Phone: 727-819-2966
  • Fax:
Mailing address:
  • Phone: 727-819-2966
  • Fax: 727-819-2928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number109726
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: