Provider Demographics
NPI:1659699072
Name:MAJCHEL KOSS, DEBORAH (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:MAJCHEL KOSS
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 1:11715 RANGELAND PKWY
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-9529
Mailing Address - Country:US
Mailing Address - Phone:941-538-0077
Mailing Address - Fax:941-538-0078
Practice Address - Street 1:11715 RANGELAND PKWY
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34211-9529
Practice Address - Country:US
Practice Address - Phone:941-538-0077
Practice Address - Fax:941-538-0078
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-10
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0037502207R00000X
FLME123174207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01570485OtherRRMCR PTAN
FLIG528ZOtherMEDICARE PTAN