Healthcare Provider Details
I. General information
NPI: 1720362262
Provider Name (Legal Business Name): CLAUDIA D ACOSTA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/03/2011
Last Update Date: 06/05/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5101 SW 8TH STREET SUITE 200
CORAL GABLES FL
33134-2442
US
IV. Provider business mailing address
5101 SW 8TH STREET SUITE 200
CORAL GABLES FL
33134-2442
US
V. Phone/Fax
- Phone: 305-913-0666
- Fax: 305-913-0663
- Phone: 305-359-5037
- Fax: 786-509-5544
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | PA9106252 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: