Healthcare Provider Details

I. General information

NPI: 1588633911
Provider Name (Legal Business Name): ANTHONY ALFREDO CORSINI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 SONATA LN
APOLLO BEACH FL
33572-2782
US

IV. Provider business mailing address

1007 SONATA LN
APOLLO BEACH FL
33572-2782
US

V. Phone/Fax

Practice location:
  • Phone: 910-358-3280
  • Fax:
Mailing address:
  • Phone: 910-358-3280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License NumberOS16251
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: