Carissa J Kostecki in Jacksonville - Pediatric Emergency Medicine
Carissa J Kostecki - NPI 1720006828
Carissa J Kostecki is a Pediatric Emergency Medicine in Jacksonville, Florida. Carissa J Kostecki practices all healthcare services and medical treatments related to Pediatric Emergency Medicine. The NPI Number for Carissa J Kostecki is 1720006828. The last update date is 2008-04-17.
Carissa J Kostecki's current location address is 820 Prudential Dr Ste 713, Jacksonville, Florida. You can contact this provider via phone number 9043965682 and fax number 9043460864. The mailing address for Carissa J Kostecki is 820 Prudential Dr Ste 713, Jacksonville, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Carissa J Kostecki |
|---|---|
| Address | 820 Prudential Dr Ste 713, Jacksonville, Florida |
| Phone Number | 9043965682 |
| Fax Number | 9043460864 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1720006828 |
|---|---|
| Provider Enumeration Date | 2006-07-17 |
| Last Updated Date | 2008-04-17 |
Provider Mailing Address Detail
| Address | 820 Prudential Dr Ste 713 |
|---|---|
| City | Jacksonville |
| State | Florida (FL) |
| Post Code | 322078209 |
| Phone Number | 9043965682 |
| Fax Number | 9043460864 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Emergency Medicine |
|---|---|
| Taxonomy | 2080P0204X |
| Licence No | ME85233 |
|
Definition: A pediatrician who has special qualifications to manage emergencies in infants and children. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 265150500 | FL | -- | |
| 29056 | FL | BCBS | |
| 000960352A | GA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Carissa J Kostecki by the Centers for Medicare & Medicaid Services (CMS)?
The Carissa J Kostecki has been assigned the NPI (National Provider Identifier) 1720006828. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you share the physical location details of Carissa J Kostecki?
The Carissa J Kostecki is situated at 820 Prudential Dr Ste 713, in the city of Jacksonville, state of FL, with the zip code 322078209.
What is Carissa J Kostecki's specialized field of practice, and what is the corresponding taxonomy classification code?
The Carissa J Kostecki's area of specialization is Pediatric Emergency Medicine, and the corresponding taxonomy code that categorizes this field of practice is 2080P0204X.
On what date did the Centers for Medicare & Medicaid Services assign the 1720006828 to Carissa J Kostecki?
The Centers for Medicare & Medicaid Services assigned the 1720006828 to Carissa J Kostecki on 2006-07-17.
When was the information related to Carissa J Kostecki most recently updated or refreshed?
The details pertaining to the Carissa J Kostecki, including its address, specialty, and other relevant information, were last updated or refreshed on 2008-04-17.