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General NPI Number Information
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NPI Number | 1346489507
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Entity Type | Organization
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Legal Business Name | CENTER FOR GASTROENTEROLOGY P A
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 04/14/2009
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Provider Practice Location Address
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Address Line | 12251 TAFT ST SUITE 301
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-1901
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Country | US
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Telephone | 954-433-5900
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Fax | 954-447-1933
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Provider Business Mailing Address
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Address Line | 12251 TAFT ST SUITE 301
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-1901
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Country | US
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Telephone | 954-433-5900
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Fax | 954-447-1933
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KATHERINE A KOSCHE
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Credential | M.D.
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Telephone | 954-433-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME70657
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License Number State | FL
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