MEDICARE: DR. KRISTIN MARIE KOSMERL ED.D., BCBA-D

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	103K00000X	Behavior Analyst	01-07-3218

General Provider Information

NPI Number	:	1811262702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTIN MARIE KOSMERL ED.D., BCBA-D

Provider Business Mailing Address
First Line	:	6586 HYPOLUXO RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-7678
Country	:	US
Telephone Number	:	561-247-0511
Fax Number	:	877-283-4022

Provider Business Practice Location Address
First Line	:	6586 HYPOLUXO RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-7678
Country	:	US
Telephone Number	:	561-247-0511
Fax Number	:	877-283-4022

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

Provider Enumeration Date	:	03/12/2012
Last Update Date	:	10/16/2025

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