Active NPI
Linda M Kodesch, M.D.
- Allergy & Immunology Physician
- Titusville, FL
National Provider Identifier
1699749358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- ME0049057
- Practice address
- 4300 Garden St
Titusville, FL 32796-2937 - Phone
- (321) 267-0011
- Fax
- (321) 267-0628
- NPI assigned
- Feb 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | ME0049057 | FL | Primary |
Addresses
Primary practice location
4300 Garden St
Titusville, FL 32796-2937
Mailing address
4300 Garden St
Titusville, FL 32796-2937
Phone (321) 267-0011
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0049057 | FL | MD | Allergy & Immunology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194220800000",
"number": "1699749358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 GARDEN ST",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327962937",
"telephone_number": "321-267-0011",
"fax_number": "321-267-0628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 GARDEN ST",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327962937",
"telephone_number": "321-267-0011",
"fax_number": "321-267-0628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KODESCH",
"first_name": "LINDA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-17",
"last_updated": "2007-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "FL",
"license": "ME0049057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Titusville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.