Koruth, Pothen C
Koruth, Pothen C is an sole proprietor health care provider with primary practice located at 758 N Sun Dr St # 104, Lake Mary FL 32746-2599. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Koruth, Pothen C can be contacted via phone (407) 333-3303.Contact Information
Primary practice address
758 N Sun Dr St # 104
Lake Mary FL 32746-2599
Phone: (407) 333-3303
Fax: (407) 333-3342
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | ME0072112 | Florida |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME0072112 | Florida |
Profile Details
| NPI number | 1093768400 |
|---|---|
| LBN Legal business name | Koruth, Pothen C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 18th, 2006 |
| Last updated | Mar 16th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093768400 | NPPES |
| Florida | MEDICAID | 269423900 |
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