Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | ME-0070694 | FL |
NPI | 1619086477 |
---|---|
Provider Name | Dr. James R Kosko |
First Address | St Petersburg, FL 33701-1547 |
Second Address | Orlando, FL 32835-5718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 17/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
250147300 | (05) | FL |
G06997 | (02) |