Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME124404 | FL |
NPI | 1235454638 |
---|---|
Provider Name | Dr. Raul Gustavo Gosthe |
First Address | Miami, FL 33176-7947 |
Second Address | Miami, FL 33176-7947 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2010 |
Last Update Date | 15/09/2016 |