Individual
MR. GUSTAVO J. MEDOSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
205 SW 84TH AVE, PLANTATION, FL 33324-2708
(954) 536-0767
Mailing address
6681 SW 20TH ST, PLANTATION, FL 33317-5104
(954) 536-0767
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA27822
FL
225700000X
Massage Therapist
MA19949
FL
Other
Enumeration date
10/16/2007
Last updated
11/28/2018
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