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:
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Health care specialties

SpecialtyCodeLicense #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 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093768400 NPPES
Florida MEDICAID 269423900

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