MEDICARE: SISSI COSSIO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0205X	Pediatric Endocrinology Physician	ME94631	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	262753150	OTHER	FL	TAX ID

General Provider Information

NPI Number	:	1477764207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SISSI COSSIO MD

Provider Business Mailing Address
First Line	:	1608 SE 3RD AVE FL 3
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-2564
Country	:	US
Telephone Number	:	954-217-5720
Fax Number	:	954-217-6110

Provider Business Practice Location Address
First Line	:	2300 N COMMERCE PKWY STE 113
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33326-3255
Country	:	US
Telephone Number	:	954-217-5720
Fax Number	:	954-217-6110

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	03/19/2025

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Directions to “ SISSI COSSIO MD” Practice Location

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