Individual
DR. GUS JOSEPH LEOTTA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4631 N CONGRESS AVE STE 203, WEST PALM BEACH, FL 33407-3209
(561) 530-1725
(561) 863-5576
Mailing address
4631 N CONGRESS AVE STE 203, WEST PALM BEACH, FL 33407-3209
(561) 530-1715
(561) 530-1724
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME106093
FL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
ME 106093
FL
Other
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
Enumeration date
10/18/2006
Last updated
02/04/2022
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