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Individual

AJOY KOTWAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3102 W CYPRESS ST, SUITE B, TAMPA, FL 33607
(813) 874-1404
(813) 874-9305
Mailing address
3102 W CYPRESS ST, SUITE B, TAMPA, FL 33607
(813) 874-1404
(813) 874-9305

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0065983
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
231261
WELLCARE
FL
01
25921
BCBS
FL
01
270102
AVMED
FL
01
ME0065983
STATE LIC
FL
Enumeration date
07/24/2006
Last updated
07/08/2007
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