Provider Demographics
NPI:1851511596
Name:KOSBE, GLENDA DAWN (CERTIFIED FITTER)
Entity Type:Individual
Prefix:MRS
First Name:GLENDA
Middle Name:DAWN
Last Name:KOSBE
Suffix:
Gender:F
Credentials:CERTIFIED FITTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8663 46TH AVENUE CIR W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-2447
Mailing Address - Country:US
Mailing Address - Phone:941-795-1539
Mailing Address - Fax:941-753-1482
Practice Address - Street 1:4301 32ND ST W
Practice Address - Street 2:SUITE E-4
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-2700
Practice Address - Country:US
Practice Address - Phone:941-795-1539
Practice Address - Fax:941-753-1482
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0422200001Medicare NSC