Healthcare Provider Details

I. General information

NPI: 1649818360
Provider Name (Legal Business Name): COSSETTE LANDIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2019
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 SW 75TH AVE
MIAMI FL
33155-2805
US

IV. Provider business mailing address

13810 SW 162ND TER
MIAMI FL
33177-1953
US

V. Phone/Fax

Practice location:
  • Phone: 305-322-1954
  • Fax:
Mailing address:
  • Phone: 305-322-1954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11006178
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN9374232
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: