Individual
THERESE K KOSSUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2851 TAMPA RD, PALM HARBOR, FL 34684-3314
(872) 231-3162
Mailing address
PO BOX 7410884, CHICAGO, IL 60674-0884
(702) 899-0595
(702) 977-1496
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
FL2558
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2916177 00
—
FL
Enumeration date
05/31/2006
Last updated
10/14/2025
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