Provider Demographics
NPI:1982623286
Name:KOSHY, SAJI (MD)
Entity Type:Individual
Prefix:DR
First Name:SAJI
Middle Name:
Last Name:KOSHY
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 1:13901 BRUCE B DOWNS BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-3905
Mailing Address - Country:US
Mailing Address - Phone:813-615-7265
Mailing Address - Fax:813-971-7953
Practice Address - Street 1:13901 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3905
Practice Address - Country:US
Practice Address - Phone:813-615-7262
Practice Address - Fax:813-979-7311
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95690207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276358300Medicaid
FLAJ365ZMedicare PIN