# ANGELOS KOUTSONIKOLIS MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366639262
- **Authorized official:** DR. ANGELOS KOUTSONIKOLIS MEDICAL DOCTOR (PRESIDENT)
- **Authorized official phone:** (561) 733-3546

## Contact information

- **Practice address:** 10075 JOG RD, SUITE 100, BOYNTON BEACH, FL 33437-3535
- **Practice address phone:** (561) 733-3546
- **Practice address fax:** (561) 733-3547
- **Mailing address:** 10075 JOG RD, SUITE 100, BOYNTON BEACH, FL 33437-3535
- **Mailing address phone:** (561) 733-3546
- **Mailing address fax:** (561) 733-3547

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | ME63824 | FL | Yes |

## Other

- **Enumeration date:** 09/25/2007
- **Last updated:** 04/22/2008