Provider Demographics
NPI:1154318046
Name:HOSKOTE, JAIDEEP (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIDEEP
Middle Name:
Last Name:HOSKOTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAIDEEP
Other - Middle Name:H
Other - Last Name:CHAKRAPANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:120 CYPRESS EDGE DR STE 208
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-8454
Mailing Address - Country:US
Mailing Address - Phone:386-586-4460
Mailing Address - Fax:
Practice Address - Street 1:120 CYPRESS EDGE DR STE 208
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-8454
Practice Address - Country:US
Practice Address - Phone:386-586-4460
Practice Address - Fax:386-586-4461
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87751207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000559883OtherANTHEM/BCBS
KY33932OtherLICENSE
KY6433932800Medicaid
0-505-554-6OtherECFMG
FLG86486OtherUPIN
FLME87751OtherFL LICENSE
FL267203100Medicaid
KY0040911Medicare PIN
FLME87751OtherFL LICENSE
KY00503016Medicare PIN
KY0902411Medicare PIN
KY00280061Medicare PIN
KY6433932800Medicaid
FL71045YMedicare PIN