Provider Demographics
NPI:1528233251
Name:KOSOWSKI, TOMASZ ROMAN (MD)
Entity Type:Individual
Prefix:
First Name:TOMASZ
Middle Name:ROMAN
Last Name:KOSOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3129 ALTERNATE 19
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-1503
Mailing Address - Country:US
Mailing Address - Phone:305-988-0898
Mailing Address - Fax:727-265-3420
Practice Address - Street 1:3129 ALTERNATE 19
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-1503
Practice Address - Country:US
Practice Address - Phone:305-988-0898
Practice Address - Fax:727-265-3420
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME120247208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery