Individual
HEATHER NICOLE COUSINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
3100 CORAL HILLS DR, SUITE 307, CORAL SPRINGS, FL 33065-4137
(954) 796-0400
Mailing address
900 NW 13TH ST, SUITE 206, BOCA RATON, FL 33486-2335
(561) 338-3267
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9105442
FL
Other
Enumeration date
06/13/2011
Last updated
08/19/2015
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