| Doctor Name: | MATTHEW KOLOSKY |
| NPI Number: | 1023459211 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O |
| License Number: | UO3454 |
| Business Practice Address: | 1800 Se Tiffany Ave Port St Lucie, FL - 349527521 |
| Business Phone Number: | 7723354000 |
| Business Fax Number: | |
| Mailing Address: | 3619 Nw Adriatic Ln, JENSEN BEACH |
| State: | FL |
| Postal Code: | 349573112 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/16/2013 |
| NPI Last Update Date: | 07/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | UO3454 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |