Healthcare Provider Details

I. General information

NPI: 1669080438
Provider Name (Legal Business Name): LINA MARTINEZ ACOSTA MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2020
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14505 COMMERCE WAY STE 800
MIAMI LAKES FL
33016-1599
US

IV. Provider business mailing address

2075 SW 122ND AVE APT 418
MIAMI FL
33175-7338
US

V. Phone/Fax

Practice location:
  • Phone: 305-910-0408
  • Fax: 305-558-1500
Mailing address:
  • Phone: 786-805-9990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11008121
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: