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:
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Health care specialties

SpecialtyCodeLicense #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 2 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 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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