Individual
DR. MICHAEL ANTHONY CUSUMANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
178 E DAVIS BLVD, TAMPA, FL 33606-3514
(813) 300-7839
(813) 425-9342
Mailing address
178 E DAVIS BLVD, TAMPA, FL 33606-3514
(813) 300-7839
(813) 425-9342
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2471
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620343400
—
FL
Enumeration date
01/03/2006
Last updated
02/18/2017
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