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Individual

DR. DARLENE P. DA COSTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2815 S SEACREST BLVD, ATTENTION: BETSY COX, BOYNTON BEACH, FL 33435-7934
(561) 736-1200
(561) 742-1919
Mailing address
200 KNUTH RD, SUITE 200, BOYNTON BEACH, FL 33436-4629
(561) 736-1200
(561) 742-1919

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME 101544
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000123600
FL
01
44026
BLUE CROSS BLUE SHIELD
FL
01
ME 101544
MEDICAL LICENSE NUMBER
FL
Enumeration date
05/19/2008
Last updated
09/11/2008
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