Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | ME84621 | FL |
NPI | 1033101704 |
---|---|
Provider Name | Michael J Szostak |
First Address | Oxford, FL 34484-2951 |
Second Address | Safety Harbor, FL 34695 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2005 |
Last Update Date | 01/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H08106 | (02) |