Healthcare Provider Details

I. General information

NPI: 1972957892
Provider Name (Legal Business Name): ALEXANDER P KOSSAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2016
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 MEMORIAL MEDICAL PKWY STE 308
DAYTONA BEACH FL
32117-5137
US

IV. Provider business mailing address

3 ADVENTHEALTH WAY UNIT 220
PALM COAST FL
32137-4708
US

V. Phone/Fax

Practice location:
  • Phone: 386-231-3600
  • Fax: 386-231-3602
Mailing address:
  • Phone: 386-231-3513
  • Fax: 386-231-3612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberME180116
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: