Leotta, Gus Joseph
Leotta, Gus Joseph is an individual health care provider with primary practice located at 4631 N Congress Ave Ste 203 , West Palm Beach FL 33407-3209. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Leotta, Gus Joseph can be contacted via phone (561) 530-1725.Contact Information
Primary practice address
4631 N Congress Ave Ste 203
West Palm Beach FL 33407-3209
Phone: (561) 530-1725
Fax: (561) 863-5576
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | ME106093 | Florida |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | ME 106093 | Florida |
Profile Details
| NPI number | 1336220771 |
|---|---|
| LBN Legal business name | Leotta, Gus Joseph |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 18th, 2006 |
| Last updated | Feb 4th, 2022 - about 4 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 | 1336220771 | NPPES |
| Georgia | Other | 051347 | GEORGIA STATE LICENSE |
| Georgia | Other | AFE 73482 | GEORGIA STATE LICENSE |
| Georgia | MEDICAID | 007381500 | GEORGIA STATE LICENSE |
| Georgia | Other | ME 106093 | GEORGIA STATE LICENSE |
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