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Contact Information

LISA A COSGROVE, MD
270 N SYKES CREEK PKWY
UNIT 108
MERRITT ISLAND, FL32953
 Phone: 321-452-1061
 Fax: 321-453-0866
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for LISA A COSGROVE · (Female)

NPI # 1598722621
Status Active
Credentials MD
Entity Individual
Enumeration date 05/01/2006
Last updated 09/22/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME59169
  • FL Medicaid 372574000
  • FL Other 18653 BLUE CROSS BLUE SHIELD FL
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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