Individual
SUSANNA MARIE COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
38184 MEDICAL CENTER AVE, ZEPHYRHILLS, FL 33540-1380
(813) 715-2812
(813) 715-2814
Mailing address
1725 OAKWOOD CT, LUTZ, FL 33558-5218
(813) 267-7888
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP11001077
FL
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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