Individual
JEANETTE KOSTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
110 LONGWOOD AVE, ROCKLEDGE, FL 32955-2828
(407) 667-0444
(407) 667-4338
Mailing address
291 SOUTHHALL LN, SUITE 201, MAITLAND, FL 32751-7274
(407) 667-0444
(407) 667-4338
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME70370
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31970
BCBS
FL
Enumeration date
06/11/2006
Last updated
02/15/2008
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