MEDICARE: ANGELOS KOUTSONIKOLIS

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	207K00000X	Allergy & Immunology Physician	ME63824	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295847978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELOS KOUTSONIKOLIS

Provider Business Mailing Address
First Line	:	10075 S JOG RD STE 100
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3532
Country	:	US
Telephone Number	:	561-733-3546
Fax Number	:	561-733-3547

Provider Business Practice Location Address
First Line	:	10075 S JOG RD STE 100
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3532
Country	:	US
Telephone Number	:	561-733-3546
Fax Number	:	561-733-3547

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	01/10/2023

Similar Medicare Providers

1720739212 — ROBERTA GOODEN APRN
Practice Location Address:

10075 S JOG RD STE 101
BOYNTON BEACH, FL
33437-3532

Practice Phone: 561-652-8652
Practice Fax: 561-652-8653

1487748596 — WOLPE-FINKBEINER, M.D. PA
Practice Location Address:

10075 JOG RD STE 108
BOYNTON BEACH, FL
33437-3532

Practice Phone: 561-736-4321
Practice Fax: 561-733-2466

1144380189 — DR. KENNETH D RUBINSTEIN DMD
Practice Location Address:

10075 S JOG RD STE 108
BOYNTON BEACH, FL
33437-3532

Practice Phone: 561-738-9007
Practice Fax: 561-738-9963

1619394194 — DR. LINDSAY HILL DMD
Practice Location Address:

10075 S JOG RD STE 108
BOYNTON BEACH, FL
33437-3532

Practice Phone: 561-693-1736
Practice Fax:

1225426729 — DR. SCOTT SPENCER DMD
Practice Location Address:

10075 S JOG RD STE 108
BOYNTON BEACH, FL
33437-3532

Practice Phone: 561-738-9007
Practice Fax: 561-738-9963

1104207703 — DR. PABLO ROBERTO PRADO D.M.D.
Practice Location Address:

10075 S JOG RD STE 102
BOYNTON BEACH, FL
33437-3532

Practice Phone: 561-244-7022
Practice Fax:

Directions to “ ANGELOS KOUTSONIKOLIS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.