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Individual

OCTAVIO COSME-MONTALVO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3010 E 138TH AVE STE 12, TAMPA, FL 33613
(813) 975-2800
(813) 977-7631
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
ME79294
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME79294
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26001
BLUE CROSS
FL
05
262967400
FL
Enumeration date
08/26/2005
Last updated
11/06/2024
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