Healthcare Provider Details

I. General information

NPI: 1144240276
Provider Name (Legal Business Name): JOSE LUIS ACOSTA PHARM.D., C.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NW 22ND AVE
MIAMI FL
33142-8429
US

IV. Provider business mailing address

11316 NW 52ND LN
DORAL FL
33178-3508
US

V. Phone/Fax

Practice location:
  • Phone: 786-466-3000
  • Fax: 305-638-6880
Mailing address:
  • Phone: 305-463-9931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS28338
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: