Provider Demographics
NPI:1891763934
Name:COSMO, LEONARD Y (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:Y
Last Name:COSMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2919 W SWANN AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4097
Mailing Address - Country:US
Mailing Address - Phone:813-879-7726
Mailing Address - Fax:813-876-2489
Practice Address - Street 1:2919 W SWANN AVE STE 202
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4097
Practice Address - Country:US
Practice Address - Phone:813-879-7726
Practice Address - Fax:813-876-2489
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0041198207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
D54154Medicare UPIN
FL30880YMedicare PIN