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General NPI Number Information
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NPI Number | 1548781586
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Entity Type | Individual
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Provider Name | COSSETTE MAIQUEZ ARNP
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Gender | Female
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 448 MORGAN CIRCLE SOUTH
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City | LEHIGH ACRES
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State | FL
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Zip | 33936
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Country | US
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Telephone | 239-771-9046
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Fax |
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Provider Business Mailing Address
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Address Line | 448 MORGAN CIR S
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City | LEHIGH ACRES
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State | FL
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Zip | 33936-7225
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Country | US
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Telephone | 239-771-9046
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9231086
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License Number State | FL
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