Provider Demographics
NPI:1649226481
Name:KOSCINSKI, FELICE I (MD)
Entity Type:Individual
Prefix:
First Name:FELICE
Middle Name:I
Last Name:KOSCINSKI
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:PO BOX 863639
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-3639
Mailing Address - Country:US
Mailing Address - Phone:888-680-6067
Mailing Address - Fax:800-536-8431
Practice Address - Street 1:400 HEALTH PARK BLVD
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5784
Practice Address - Country:US
Practice Address - Phone:904-826-4700
Practice Address - Fax:800-536-8431
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0070986207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL32725OtherBCBS
FL32725BMedicare PIN
FL32725DMedicare ID - Type Unspecified
FL32725OtherBCBS