Provider Demographics
NPI:1093010720
Name:COSAMANO, VALERIE LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:LYNN
Last Name:COSAMANO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:LYNN
Other - Last Name:WENGERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7324 SOUTHWEST FWY STE 1550
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2053
Mailing Address - Country:US
Mailing Address - Phone:713-779-9800
Mailing Address - Fax:
Practice Address - Street 1:29277 US 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2102
Practice Address - Country:US
Practice Address - Phone:727-313-4764
Practice Address - Fax:832-804-8813
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105825246ZC0007X, 363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003105600Medicaid
FLE09767YOtherMEDICARE PTAN