MEDICARE: ROBERT ANTHONY KOZOL MD

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	208600000X	Surgery Physician	ME105599	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	:	1598761587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT ANTHONY KOZOL MD

Provider Business Mailing Address
First Line	:	5301 S CONGRESS AVE
Second Line	:	FLOOR 3S
City	:	ATLANTIS
State	:	FL
Zip	:	33462
Country	:	US
Telephone Number	:	561-548-1711
Fax Number	:	561-548-1743

Provider Business Practice Location Address
First Line	:	142 JFK DRIVE
Second Line	:
City	:	ATLANTIS
State	:	FL
Zip	:	33462
Country	:	US
Telephone Number	:	561-439-1500
Fax Number	:	561-548-1743

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	06/24/2014

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