Individual
DAVID M COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A. - C
Contact information
Practice address
1285 ORANGE AVE, WINTER PARK, FL 32789-4984
(407) 599-3710
(407) 643-2807
Mailing address
1285 ORANGE AVE, WINTER PARK, FL 32789-4984
(407) 599-3710
(407) 643-2807
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2227
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290340700
—
FL
Enumeration date
12/07/2005
Last updated
11/24/2020
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