Individual
MR. KEITH THOMAS COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
3310 SW 34TH ST, OCALA, FL 34474-7422
(352) 873-0707
Mailing address
3310 SW 34TH ST, OCALA, FL 34474-7422
(352) 873-9557
(352) 873-1842
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11024420
FL
Other
Enumeration date
02/07/2023
Last updated
02/17/2023
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