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General NPI Number Information
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NPI Number | 1083665269
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Entity Type | Individual
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Provider Name | VICTOR S KOO M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/13/2006
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 2623 S SEACREST BLVD SUITE 216
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-7501
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Country | US
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Telephone | 561-736-3888
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Fax | 561-732-1737
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Provider Business Mailing Address
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Address Line | 4415 WOODFIELD BLVD
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City | BOCA RATON
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State | FL
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Zip | 33434-5303
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Country | US
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Telephone | 561-736-3888
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Fax | 561-732-1737
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | ME37667
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License Number State | FL
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