# DR. GUS JOSEPH LEOTTA III

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1336220771
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | ME106093 | FL | Yes |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | ME 106093 | FL | — |

## Other

- **Enumeration date:** 10/18/2006
- **Last updated:** 02/04/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 007381500 | — | FL |
| 01 | — | 051347 | GEORGIA STATE LICENSE | GA |
| 01 | — | AFE 73482 | PHYSICIAN AND SURGEON | CA |
| 01 | — | ME 106093 | MEDICAL BOARD OF FLORIDA | FL |