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NPI Code Detail

MEDICARE: KIRAN LUKOSE M.D

MEDICARE: KIRAN LUKOSE 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
1207Q00000XFamily Medicine Physician17371FL

Other Identifiers

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

General Provider Information

NPI Number : 1548529548
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRAN LUKOSE M.D
Provider Business Mailing Address
First Line : 1707 N MAIN ST
Second Line :
City : GAINESVILLE
State : FL
Zip : 32609-3650
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1707 N MAIN ST
Second Line :
City : GAINESVILLE
State : FL
Zip : 32609-3650
Country : US
Telephone Number : 352-392-4541
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2012
Last Update Date : 07/24/2015

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Directions to “ KIRAN LUKOSE M.D” Practice Location

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