Healthcare Provider Details

I. General information

NPI: 1790145084
Provider Name (Legal Business Name): ANOUCHKA COSTE HOLT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANOUCHKA HELENE COSTE D.O.

II. Dates (important events)

Enumeration Date: 02/29/2016
Last Update Date: 01/23/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CLINT MOORE RD STE 210
BOCA RATON FL
33487-5716
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 561-488-1801
  • Fax: 561-451-1480
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number20A19562
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number296231
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS20225
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: