MEDICARE: JAMES KOS MD PLLC

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1609589886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES KOS MD PLLC

Provider Business Mailing Address
First Line	:	1930 NE 47TH ST STE 100
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-7704
Country	:	US
Telephone Number	:	954-609-9161
Fax Number	:

Provider Business Practice Location Address
First Line	:	1930 NE 47TH ST STE 100
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-7704
Country	:	US
Telephone Number	:	954-609-9161
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	JAMES KOS
Credential	:	MD
Telephone Number	:	954-609-9161

Provider Enumeration Date	:	01/03/2023
Last Update Date	:	01/03/2023

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