Individual
DR. CARLOS ENRIQUE FOSSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M,D.
Contact information
Practice address
5030 KINGSWOOD DR, LAKELAND, FL 33813-3026
(863) 274-0853
(863) 582-9436
Mailing address
5030 KINGSWOOD DR, LAKELAND, FL 33813-3026
(863) 274-0853
(863) 582-9436
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
ME51410
FL
310400000X
Assisted Living Facility
ME51410
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0644056-00
—
FL
Enumeration date
07/25/2006
Last updated
01/29/2014
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