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General NPI Number Information
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NPI Number | 1912957994
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Entity Type | Individual
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Provider Name | CARMEN D COSME MD
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Gender | Female
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 7945 S SUNCOAST BLVD STE A-B
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City | HOMOSASSA
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State | FL
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Zip | 34446-5005
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Country | US
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Telephone | 352-423-4923
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Fax |
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Provider Business Mailing Address
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Address Line | 1425 S US 301
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City | SUMTERVILLE
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State | FL
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Zip | 33585-5141
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Country | US
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Telephone | 352-793-5900
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 10120
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 4301080986
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License Number State | MI
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