Individual
DR. CAROL COSTAS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2403 RIVER HAMMOCK LN, FORT PIERCE, FL 34981-4989
(772) 519-2418
Mailing address
2403 RIVER HAMMOCK LN, FORT PIERCE, FL 34981-4989
(772) 519-2418
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME41952
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56127
BLUECROSS
FL
Enumeration date
03/28/2006
Last updated
07/08/2007
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