Healthcare Provider Details

I. General information

NPI: 1215329552
Provider Name (Legal Business Name): JOSEPH COSCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 02/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 BERMUDA LAKE DR
PALM BEACH GARDENS FL
33418-4584
US

IV. Provider business mailing address

28 BERMUDA LAKE DR
PALM BEACH GARDENS FL
33418-4584
US

V. Phone/Fax

Practice location:
  • Phone: 561-635-8544
  • Fax:
Mailing address:
  • Phone: 561-635-8544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: