Individual
ANTHONY DICOSTANZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
401 VENTURE DR, SOUTH DAYTONA, FL 32119-3478
(386) 761-8888
Mailing address
401 VENTURE DR, SOUTH DAYTONA, FL 32119-3478
(386) 837-0958
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11039273
FL
Other
Enumeration date
05/06/2025
Last updated
03/11/2026
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