MEDICARE: FRANCES JACINTO ACOSTA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	ME125173	FL
2	207W00000X	Ophthalmology Physician	ME125173	FL

General Provider Information

NPI Number	:	1770826745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCES JACINTO ACOSTA M.D.

Provider Business Mailing Address
First Line	:	529 W DAVIS BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-4012
Country	:	US
Telephone Number	:	813-363-7787
Fax Number	:

Provider Business Practice Location Address
First Line	:	206 BUCKINGHAM PL STE 102
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-4910
Country	:	US
Telephone Number	:	813-653-2020
Fax Number	:	813-653-2205

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2013
Last Update Date	:	06/16/2018

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