Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | ME94631 | FL |
NPI | 1477764207 |
---|---|
Provider Name | Sissi Cossio |
First Address | Plantation, FL 33324-3920 |
Second Address | Parkland, FL 33067 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 23/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000861000 | (05) | FL |
262753150 | TAX ID (01) | FL |