Healthcare Provider Details

I. General information

NPI: 1922647189
Provider Name (Legal Business Name): KRIS ELAINE SOSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2020
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41232 US HIGHWAY 19 N
TARPON SPRINGS FL
34689-5106
US

IV. Provider business mailing address

9492 MINNOW RAY DR
LAND O LAKES FL
34638-5929
US

V. Phone/Fax

Practice location:
  • Phone: 727-940-9295
  • Fax:
Mailing address:
  • Phone: 720-219-8749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14502
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS51645
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: