Provider Demographics
NPI:1033440946
Name:KOZMAN, SAMIA SABA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMIA
Middle Name:SABA
Last Name:KOZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4415 US HIGHWAY 331 S
Mailing Address - Street 2:
Mailing Address - City:DEFUNIAK SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32435-6307
Mailing Address - Country:US
Mailing Address - Phone:850-951-4500
Mailing Address - Fax:850-892-7079
Practice Address - Street 1:4415 US HIGHWAY 331 S
Practice Address - Street 2:
Practice Address - City:DEFUNIAK SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32435-6307
Practice Address - Country:US
Practice Address - Phone:850-951-4500
Practice Address - Fax:850-892-7079
Is Sole Proprietor?:No
Enumeration Date:2010-01-18
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME105683207Q00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME105683OtherFLORIDA MEDICAL LICENSE