Decosmo, John B
Decosmo, John B is an individual health care provider with primary practice located at 4800 4Th St N , Saint Petersburg FL 33703-3817. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Decosmo, John B can be contacted via phone (727) 698-2056.Contact Information
Primary practice address
4800 4Th St N
Saint Petersburg FL 33703-3817
Phone: (727) 698-2056
Fax: (727) 541-3956
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | OS5534 | Florida |
Profile Details
| NPI number | 1396721221 |
|---|---|
| LBN Legal business name | Decosmo, John B |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 22nd, 2005 |
| Last updated | Sep 20th, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396721221 | NPPES |
| Florida | MEDICAID | 0493287 00 |
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