Individual
MARY KOSHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5325 E STATE ROAD 64, BRADENTON, FL 34208-5534
(941) 220-6263
(386) 490-9100
Mailing address
1860 BOY SCOUT DR STE 201, FORT MYERS, FL 33907-2119
(239) 215-1180
(239) 215-1179
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME92795
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17238
BCBS OF FL
FL
05
—
278934500
—
FL
01
—
309040
AVMED
FL
01
—
3446756
CIGNA
FL
01
—
505100
WELLCARE
FL
01
—
7763556
AETNA
FL
01
—
P00421717
RAILROAD MEDICARE
FL
01
—
P00898040
RR MEDICARE
FL
01
—
P01257637
RAILROAD MCR
FL
05
—
P502151
—
FL
01
—
P940526
OPTIMUM
FL
01
—
P983665
FREEDOM HEALTH
FL
01
—
PT087
MEDICARE
FL
01
—
PT091
MEDICARE
FL
Enumeration date
09/15/2006
Last updated
09/12/2022
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