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Dennis Eric Koselak

Anesthesiology

Allopathic & Osteopathic Physicians

2010 59th St W, Ste 5600, Bradenton, FL 34209-4686

PECOS Enrollment

This provider is enrolled in PECOS as DENNIS KOSELAK.

Based on the most recent information from CMS, provider Dennis Eric Koselak is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1386607919
Provider Type
Individual
Full Name
Koselak, Dennis Eric
Title
Dr.

Credential
M.D.
Gender
Male
Enumeration Date
4/6/2006
Last Updated
7/8/2007

Contact Information

Practice Location

2010 59th St W, Ste 5600, Bradenton, FL 34209-4686

(941) 798-3524

Unlisted Fax

Mailing Location

PO Box 552106, Tampa, FL 33655-0001

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207L00000X Primary	Description Anesthesiology Allopathic & Osteopathic Physicians	License ME80905 Florida

Dennis Eric Koselak

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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