Elizabeth Palachicacka Koshi, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME209029 Issued in FL

Practice address

1805 Hobbs Rd
Auburndale, FL 33823-4644

Phone

(863) 965-5400

Fax

(863) 965-3739

NPI assigned

Oct 11, 2005

Last updated

Aug 11, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University Medical Service Association Inc

  • Neurological Surgery Physician
  • Tampa, FL
  • NPI 1740227966
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1255329504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 GOLFVIEW AVE",
            "address_2": "4TH FLOOR ATTN: BILLING DEPARTMENT",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338306738",
            "telephone_number": "863-519-7900",
            "fax_number": "863-519-7696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 HOBBS RD",
            "city": "AUBURNDALE",
            "state": "FL",
            "postal_code": "338234644",
            "telephone_number": "863-965-5400",
            "fax_number": "863-965-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSHI",
        "first_name": "ELIZABETH",
        "middle_name": "PALACHICACKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME209029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069749400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorrie Jernigan
• JJS Caring Hands LLC
• Willie Johnson, GM
• Keith Jordan
• Nancy Davis King, M.D.
• Michael Joseph Kyser
• Lake Myrtle Center for Advanced Dentistry
• Lakeland Regional Health Systems, Inc.
• Kimberley Lawrence
• Crystalyn Lawson

• Pediatrics Physician in Auburndale, FL
• Providers in Auburndale, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.