Provider Demographics
NPI:1962602870
Name:KOSSOW, EDINA GALE (ECHOCARDIOGRAPHER)
Entity type:Individual
Prefix:
First Name:EDINA
Middle Name:GALE
Last Name:KOSSOW
Suffix:
Gender:F
Credentials:ECHOCARDIOGRAPHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9648 US HIGHWAY 301 S
Mailing Address - Street 2:#208
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-5442
Mailing Address - Country:US
Mailing Address - Phone:813-335-1127
Mailing Address - Fax:
Practice Address - Street 1:9648 US HIGHWAY 301 S
Practice Address - Street 2:#208
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-5442
Practice Address - Country:US
Practice Address - Phone:813-335-1127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography