Individual
MATHEW KOSHY KANDATHIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
91550 OVERSEAS HWY STE 205, TAVERNIER, FL 33070-2513
(305) 434-3400
Mailing address
PO BOX 100707, ATLANTA, GA 30384-0707
(305) 434-3400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
40740
NJ
207RG0100X
Gastroenterology Physician
40612
MA
207RG0100X
Gastroenterology Physician
Primary
ME139797
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3533409
—
NJ
Enumeration date
08/18/2005
Last updated
09/03/2025
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