Organization
COSMO J ANASTASI O D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COSMO J ANASTASI O D (PRESIDENT)
(813) 866-9255
Entity
Organization
Contact information
Practice address
2021 W BRANDON BLVD, BRANDON, FL 33511-4701
(813) 657-5448
(813) 657-5449
Mailing address
16313 ASHINGTON PARK DR, TAMPA, FL 33647-2644
(813) 866-9255
(813) 866-0445
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 1016
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K7916
MEDICARE GRP#
FL
Enumeration date
06/25/2007
Last updated
07/11/2007
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