Provider Demographics
NPI:1518211820
Name:KOSOWSKI, KENNETH ALFRED (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:ALFRED
Last Name:KOSOWSKI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8585 COLLIER BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114
Mailing Address - Country:US
Mailing Address - Phone:239-774-2938
Mailing Address - Fax:239-774-6974
Practice Address - Street 1:8585 COLLIER BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114
Practice Address - Country:US
Practice Address - Phone:239-774-2938
Practice Address - Fax:239-774-2938
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS44651183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist