Provider Demographics
NPI:1548063332
Name:CSMLT LLC
Entity type:Organization
Organization Name:CSMLT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GENEVA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TONUZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:785-224-9743
Mailing Address - Street 1:13475 ATLANTIC BLVD SUITE 8, #423
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 TYRONE BLVD N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-6309
Practice Address - Country:US
Practice Address - Phone:785-224-9743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty