Healthcare Provider Details

I. General information

NPI: 1366361735
Provider Name (Legal Business Name): ISIS VALDES ACOSTA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 W 74TH ST APT 110
HIALEAH FL
33014-4689
US

IV. Provider business mailing address

1140 W 74TH ST APT 110
HIALEAH FL
33014-4689
US

V. Phone/Fax

Practice location:
  • Phone: 786-764-4693
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN32204
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: