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General NPI Number Information
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NPI Number | 1437500790
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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 | 06/28/2016
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Last Update Date | 06/28/2016
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Provider Practice Location Address
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Address Line | PR- 9921 LOTE 8 PARQUE INDUSTRIAL TEJAS
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City | LAS PIEDRAS
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State | PR
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Zip | 00771
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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 |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | 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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