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General NPI Number Information
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NPI Number | 1396052510
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Entity Type | Individual
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Provider Name | DIANA SUSAN KOSHY M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/09/2010
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Last Update Date | 07/24/2015
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Provider Practice Location Address
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Address Line | 200 N LAKEMONT AVE
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City | WINTER PARK
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State | FL
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Zip | 32792-3273
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Country | US
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Telephone | 407-473-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 3934 MUZANTE CT
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City | ORLANDO
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State | FL
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Zip | 32817-1653
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Country | US
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Telephone | 407-473-3900
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Fax |
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME115375
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License Number State | FL
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