Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | PO-0001221 | FL |
N | 213ES0000X | Sports Medicine | PO-0001221 | FL |
Y | 213ES0103X | Foot & Ankle Surgery | PO-0001221 | FL |
N | 213ES0131X | Foot Surgery | PO-0001221 | FL |
NPI | 1477595361 |
---|---|
Provider Name | Gerald Louis Cosentino |
First Address | Tampa, FL 33609-4181 |
Second Address | Tampa, FL 33609-4181 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 03/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
041093400 | (05) | FL |
T95171 | (02) | FL |