Organization
FOUR CORNERS MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SRINATH R KOSANAM MD (PRESIDENT-OWNER)
(407) 844-7323
Entity
Organization
Contact information
Practice address
106 POLO PARK EAST BLVD, DAVENPORT, FL 33897-9407
(863) 424-8900
(863) 424-8823
Mailing address
10603 EMERALD CHASE DR, ORLANDO, FL 32836-5855
(407) 844-7323
(863) 424-8823
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/10/2026
Last updated
04/10/2026
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