Provider Demographics
NPI:1821419698
Name:KOSEK, KURT
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:
Last Name:KOSEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 MILLBRAE CT
Mailing Address - Street 2:#6
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-8470
Mailing Address - Country:US
Mailing Address - Phone:239-410-7725
Mailing Address - Fax:
Practice Address - Street 1:135 BRADLEY PL
Practice Address - Street 2:
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-3819
Practice Address - Country:US
Practice Address - Phone:561-655-4120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-21
Last Update Date:2013-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS50918183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist