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General NPI Number Information
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NPI Number | 1003288341
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Entity Type | Organization
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Legal Business Name | COSSMA, INC
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | CARR 722 KM 6.4 BO ROBLES-RABANAL
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City | AIBONITO
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State | PR
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Zip | 00705
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Country | US
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Telephone | 787-739-8182
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1330
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City | CIDRA
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State | PR
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Zip | 00739-1330
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Country | US
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Telephone | 787-739-8182
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Fax | 787-739-8190
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. ISOLINA MIRANDA
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Credential |
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Telephone | 787-739-8182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 86
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License Number State | PR
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