Individual
ALLA KOSTOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1370 E VENICE AVE STE 202, VENICE, FL 34285-9084
(941) 480-0500
(941) 480-9322
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(778) 563-7748
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9554103
FL
363LF0000X
Family Nurse Practitioner
Primary
APRN11035174
FL
Other
Enumeration date
02/24/2023
Last updated
08/22/2025
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