Individual
DR. GUSTAVO COSTA MUNGUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
5301 S CONGRESS AVE, 3 SOUTH, ATLANTIS, FL 33462-1149
(561) 548-1711
Mailing address
5301 S CONGRESS AVE, 3 SOUTH, ATLANTIS, FL 33462-1149
(561) 548-1711
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME145091
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2015
Last updated
06/22/2020
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