MEDICARE: DR. JAIDEEP HOSKOTE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	ME87751	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000559883	OTHER	KY	ANTHEM/BCBS
2	33932	OTHER	KY	LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0-505-554-6	OTHER		ECFMG
5	G86486	OTHER	FL	UPIN
6	ME87751	OTHER	FL	FL LICENSE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154318046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAIDEEP HOSKOTE M.D.

Provider Business Mailing Address
First Line	:	120 CYPRESS EDGE DR STE 208
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-8454
Country	:	US
Telephone Number	:	386-586-4460
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 CYPRESS EDGE DR STE 208
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-8454
Country	:	US
Telephone Number	:	386-586-4460
Fax Number	:	386-586-4461

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	01/16/2020

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Directions to “ DR. JAIDEEP HOSKOTE M.D.” Practice Location

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