Costello, Michael J

Costello, Michael J is an individual health care provider with primary practice located at 2215 Nebraska Ave Suite 3D, Fort Pierce FL 34950-4864. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Costello, Michael J can be contacted via phone (772) 461-4666.

Contact Information

Primary practice address
2215 Nebraska Ave Suite 3D Fort Pierce FL 34950-4864
Phone: (772) 461-4666
Fax: (772) 464-3005
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X ME0026473 Florida
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X ME0026473 Florida
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X ME0026473 Florida

Profile Details

NPI number 1366470403
LBN Legal business name Costello, Michael J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Jan 23rd, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366470403 NPPES
Florida MEDICAID 056288200
Florida Other 50734
Florida Other 4245215
Florida Other 021998467

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