Provider Demographics
NPI:1003823972
Name:KOSCHE, KATHERINE A (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:A
Last Name:KOSCHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12251 TAFT STREET
Mailing Address - Street 2:SUITE 401
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026
Mailing Address - Country:US
Mailing Address - Phone:954-433-5900
Mailing Address - Fax:954-447-1933
Practice Address - Street 1:12251 TAFT STREET
Practice Address - Street 2:SUITE 401
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026
Practice Address - Country:US
Practice Address - Phone:954-433-5900
Practice Address - Fax:954-447-1933
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME70657207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL31985WOtherPTAN
FL254195800Medicaid
FL31985WOtherPTAN
FL31985Medicare ID - Type Unspecified