| Ajoy Kotwal Md Pa | |
|
3102 W Cypress St Suite B Tampa FL 33607-5118 | |
| (813) 874-1404 | |
| (813) 874-9305 |
| Full Name | Ajoy Kotwal Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 3102 W Cypress St, Tampa, Florida |
| Authorized Official Name and Position | Ajoy Kotwal (OWNER) |
| Authorized Official Contact | 8138741404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ajoy Kotwal Md Pa 3102 W Cypress St Suite B Tampa FL 33607-5118 Ph: (813) 874-1404 | Ajoy Kotwal Md Pa 3102 W Cypress St Suite B Tampa FL 33607-5118 Ph: (813) 874-1404 |
| NPI Number | 1639427396 |
|---|---|
| Provider Enumeration Date | 08/28/2012 |
| Last Update Date | 08/28/2012 |
| Medicare PECOS PAC ID | 0345498606 |
|---|---|
| Medicare Enrollment ID | O20120912000397 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639427396 | NPI | - | NPPES |
| 270102 | Other | FL | AVMED |
| 25921 | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0065983 (Florida) | Primary |
| Provider Name | Ajoy Kotwal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811919657 PECOS PAC ID: 3577458926 Enrollment ID: I20040216001082 |
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