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Individual

JOSEPH F COSTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1313 TRAIL GLEN LN, LUTZ, FL 33549-4083
(813) 727-3591
(813) 747-9601
Mailing address
1313 TRAIL GLEN LN, LUTZ, FL 33549-4083
(813) 727-3591
(813) 747-9601

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
213650
FL

Other

Enumeration date
07/08/2010
Last updated
07/08/2010
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