Provider Demographics
NPI:1770571739
Name:GOSZKOWSKI, JAMES HENRY (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HENRY
Last Name:GOSZKOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:601 S HARBOUR ISLAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5925
Mailing Address - Country:US
Mailing Address - Phone:727-322-3439
Mailing Address - Fax:800-928-7449
Practice Address - Street 1:2765 NW 49TH AVE UNIT 304
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34482-6215
Practice Address - Country:US
Practice Address - Phone:352-619-0848
Practice Address - Fax:844-388-6186
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01037052A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAE50098Medicare UPIN
IN941140M7Medicare PIN
IN000000598582OtherANTHEM
INP00670400OtherMEDICARE RAILROAD
IA0291443Medicaid
IN258190QMedicare PIN
IN200101670Medicaid
IN200101670Medicaid