Provider Demographics
NPI:1215995741
Name:KOSHES, JOSEPH J JR (RPT DC CCSP)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:KOSHES
Suffix:JR
Gender:M
Credentials:RPT DC CCSP
Other - Prefix:
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Mailing Address - Street 1:2426 BEE RIDGE RD
Mailing Address - Street 2:STE C
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239
Mailing Address - Country:US
Mailing Address - Phone:941-927-7463
Mailing Address - Fax:941-927-5522
Practice Address - Street 1:2426 BEE RIDGE RD
Practice Address - Street 2:STE C
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239
Practice Address - Country:US
Practice Address - Phone:941-927-7463
Practice Address - Fax:941-927-5522
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2011-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004610111N00000X
FLPT0002352225100000X
CTPT002252225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380376700Medicaid
T84453Medicare UPIN
70407AMedicare ID - Type UnspecifiedCHIROPRACTIC
Y2920Medicare ID - Type UnspecifiedPHYSICAL THERAPY