Provider Demographics
NPI:1205916699
Name:NEIL COSKUN, MD,PA
Entity type:Organization
Organization Name:NEIL COSKUN, MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:COSKUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-382-0606
Mailing Address - Street 1:PO BOX 34
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-0034
Mailing Address - Country:US
Mailing Address - Phone:407-382-0606
Mailing Address - Fax:407-258-8905
Practice Address - Street 1:7800 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8227
Practice Address - Country:US
Practice Address - Phone:407-382-0606
Practice Address - Fax:407-258-8905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76031207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2934Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER