Provider Demographics
NPI:1316932296
Name:KOSCHES, DANIEL SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:SCOTT
Last Name:KOSCHES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4800 NE 20TH TER STE 115
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4510
Mailing Address - Country:US
Mailing Address - Phone:954-267-8866
Mailing Address - Fax:954-267-0939
Practice Address - Street 1:4800 NE 20TH TER STE 115
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4510
Practice Address - Country:US
Practice Address - Phone:954-267-8866
Practice Address - Fax:954-267-0939
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2023-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0061573207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14674AMedicare PIN
F20965Medicare UPIN