Individual
MR. MATHIAS COSTA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
15650 SW 10TH ST, MIAMI, FL 33194-2418
(786) 543-3670
Mailing address
15650 SW 10TH ST, MIAMI, FL 33194-2418
(786) 543-3670
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL1466
FL
Other
Enumeration date
06/09/2014
Last updated
06/09/2014
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