Provider Demographics
NPI:1982678041
Name:KOUL, ASHOK (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:
Last Name:KOUL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4351 TAMIAMI TRL N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3106
Mailing Address - Country:US
Mailing Address - Phone:239-263-1777
Mailing Address - Fax:239-263-6987
Practice Address - Street 1:4351 TAMIAMI TRL N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3106
Practice Address - Country:US
Practice Address - Phone:239-263-1777
Practice Address - Fax:239-263-6789
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL88188207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274511900Medicaid
FL274511900Medicaid