Individual
ATHAN P KARTSONIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-1771
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-1771
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME42738
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02786
BLUE CROSS
FL
01
—
0580847
AETNA
FL
05
—
118202800
—
FL
01
—
QX746
MEDICARE HF
FL
Enumeration date
11/23/2005
Last updated
06/05/2023
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