Individual
KENSON LACOSSIERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 SE HOSPITAL AVE, STUART, FL 34994-2346
(772) 223-5618
(772) 288-5834
Mailing address
PO BOX 417, STUART, FL 34995-0417
(772) 781-2799
(772) 781-2716
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME114403
FL
208M00000X
Hospitalist Physician
Primary
ME114403
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007816400
—
FL
01
—
14P0S
FLORIDA BLUE
FL
Enumeration date
12/04/2008
Last updated
03/16/2017
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