Provider Demographics
NPI:1346245305
Name:CAMBIO, JOSEPH COSMO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:COSMO
Last Name:CAMBIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:207 QUAKER LN
Practice Address - Street 2:
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893-2283
Practice Address - Country:US
Practice Address - Phone:401-828-7110
Practice Address - Fax:401-827-6364
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2020-12-11
Deactivation Date:2006-03-18
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
RIMD05208174400000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI4239421OtherAETNA
RI6672168OtherCIGNA
RIAA336909OtherHARVARD PILGRIM
RIJC10893Medicaid
RIP01281045OtherRAILROAD MCR
RI1074835OtherCOVENTRY
RIJC10893Medicaid
RI6672168OtherCIGNA
RIU400115166Medicare PIN