Provider Demographics
NPI:1063590198
Name:KOSBOTH, MEGHAVI SHETH (DO)
Entity type:Individual
Prefix:DR
First Name:MEGHAVI
Middle Name:SHETH
Last Name:KOSBOTH
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:4881 NW 8TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4582
Mailing Address - Country:US
Mailing Address - Phone:352-373-6338
Mailing Address - Fax:352-373-6144
Practice Address - Street 1:4343 W NEWBERRY RD
Practice Address - Street 2:SUITE 8
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607
Practice Address - Country:US
Practice Address - Phone:352-378-5173
Practice Address - Fax:352-375-2330
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2009-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS 10014207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL279278800Medicaid
FL279278800Medicaid