Individual
DR. JOSE NICOLAS CODOLOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5398 PARK ST N, ST PETERSBURG, FL 33709-1041
(727) 544-1441
(757) 545-8263
Mailing address
5398 PARK ST N, ST PETERSBURG, FL 33709-1041
(727) 544-1441
(757) 545-8263
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME121995
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014728800
—
FL
Enumeration date
07/17/2007
Last updated
04/12/2017
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