Provider Demographics
NPI:1619086477
Name:KOSKO, JAMES R (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:KOSKO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1033 DR MARTIN LUTHER KING JR ST N
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-1547
Mailing Address - Country:US
Mailing Address - Phone:727-456-4250
Mailing Address - Fax:727-346-1044
Practice Address - Street 1:1507 S HIAWASSEE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-5718
Practice Address - Country:US
Practice Address - Phone:407-253-1000
Practice Address - Fax:407-253-1010
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2010-02-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME-0070694207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL250147300Medicaid
FL250147300Medicaid
31232ZMedicare ID - Type Unspecified