Provider Demographics
NPI:1699340869
Name:GOSSETT, JOHN KEVIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:KEVIN
Last Name:GOSSETT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-6114
Mailing Address - Country:US
Mailing Address - Phone:727-822-6896
Mailing Address - Fax:727-894-0168
Practice Address - Street 1:3851 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-6114
Practice Address - Country:US
Practice Address - Phone:727-822-6896
Practice Address - Fax:727-894-0168
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS34186183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist