Healthcare Provider Details

I. General information

NPI: 1275264756
Provider Name (Legal Business Name): LISBET CAABEIRO ACOSTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2022
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 DOGWOOD RD
WEST PALM BEACH FL
33409-4878
US

IV. Provider business mailing address

1012 DOGWOOD RD
WEST PALM BEACH FL
33409-4878
US

V. Phone/Fax

Practice location:
  • Phone: 786-380-6878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number21192926
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: