Provider Demographics
NPI:1922301720
Name:LOUIS R. GIUSTO, M.D., P.A.
Entity Type:Organization
Organization Name:LOUIS R. GIUSTO, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:GIUSTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:954-968-4400
Mailing Address - Street 1:5800 COLONIAL DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5682
Mailing Address - Country:US
Mailing Address - Phone:954-968-4400
Mailing Address - Fax:
Practice Address - Street 1:5800 COLONIAL DR
Practice Address - Street 2:SUITE 204
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5682
Practice Address - Country:US
Practice Address - Phone:954-968-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOUIS R. GIUSTO, M.D., P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME49204207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC55757Medicare UPIN