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General NPI Number Information
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NPI Number | 1437235793
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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 | 10/30/2006
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | AVE EL JIBARO CARR 172 KM 13 5
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City | CIDRA
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State | PR
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Zip | 00739
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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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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 | MS. 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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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