| Kozhimala T. John M.d. P.a. | |
|
6340 Fort King Rd Zephyrhills FL 33542 | |
| (813) 782-6116 | |
| (813) 780-1051 |
| Full Name | Kozhimala T. John M.d. P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 6340 Fort King Rd, Zephyrhills, Florida |
| Authorized Official Name and Position | Kozhimala T John (M.D./OWNER) |
| Authorized Official Contact | 8137826116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kozhimala T. John M.d. P.a. Po Box 1617 Zephyrhills FL 33539-1617 Ph: (813) 782-6116 | Kozhimala T. John M.d. P.a. 6340 Fort King Rd Zephyrhills FL 33542 Ph: (813) 782-6116 |
| NPI Number | 1215206792 |
|---|---|
| Provider Enumeration Date | 12/29/2011 |
| Last Update Date | 08/22/2018 |
| Medicare PECOS PAC ID | 0042487209 |
|---|---|
| Medicare Enrollment ID | O20120111000856 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215206792 | NPI | - | NPPES |
| 1891890638 | Other | FL | NPI (INDIVIDUAL) |
| 058391000 | Medicaid | FL | |
| 51086 | Other | FL | BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | ME23148 (Florida) | Primary |
| Provider Name | Kozhimala T John |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891890638 PECOS PAC ID: 5698804466 Enrollment ID: I20120124000882 |
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