Individual provider Active NPI

Harry M Koslowski, MD

  • Neurology Physician
  • Jacksonville, FL
National Provider Identifier
1508852344
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME62907 Issued in FL
Practice address
3550 University Blvd S
Suite 203
Jacksonville, FL 32216-4246
Phone
(904) 367-0707
Fax
(904) 367-0717
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME62907 FL Primary

Addresses

Primary practice location

3550 University Blvd S
Suite 203
Jacksonville, FL 32216-4246

Mailing address

3550 University Blvd S
Suite 203
Jacksonville, FL 32216-4246
Phone (904) 367-0707

Other identifiers 1

IdentifierTypeStateIssuer
372435200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1508852344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 UNIVERSITY BLVD S",
            "address_2": "SUITE 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164246",
            "telephone_number": "904-367-0707",
            "fax_number": "904-367-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 UNIVERSITY BLVD S",
            "address_2": "SUITE 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164246",
            "telephone_number": "904-367-0707",
            "fax_number": "904-367-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSLOWSKI",
        "first_name": "HARRY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME62907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372435200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; 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.