Provider Demographics
NPI:1154343002
Name:KOCHNO, TARAS V (MD)
Entity type:Individual
Prefix:DR
First Name:TARAS
Middle Name:V
Last Name:KOCHNO
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 1:1964 HOWELL BRANCH RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-1042
Mailing Address - Country:US
Mailing Address - Phone:407-681-2241
Mailing Address - Fax:407-679-2779
Practice Address - Street 1:3825 26TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-3507
Practice Address - Country:US
Practice Address - Phone:941-755-8819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61947174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE18493Medicare UPIN
FL23403Medicare ID - Type Unspecified