Kosanovich, Tad Robert

Kosanovich, Tad Robert is an individual health care provider with primary practice located at 150 S Indiana Ave , Englewood FL 34223-3307. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Kosanovich, Tad Robert can be contacted via phone (941) 473-1392.

Contact Information

Primary practice address
150 S Indiana Ave Englewood FL 34223-3307
Phone: (941) 473-1392
Fax: (941) 473-9379
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPC2285 Florida

Profile Details

NPI number 1285785527
LBN Legal business name Kosanovich, Tad Robert
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2007
Last updated Oct 30th, 2008 - about 17 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 1285785527 NPPES
Florida Other 410046559 RAILROAD MEDICARE
Florida MEDICAID 620138500 RAILROAD MEDICARE

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