Individual
SANTO NICOSIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12901 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4742
(813) 974-2201
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME51432
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
049264700
—
FL
01
—
07687Z
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/12/2006
Last updated
05/02/2008
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