Healthcare Provider Details

I. General information

NPI: 1942906722
Provider Name (Legal Business Name): JESSICA ACOSTA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2023
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 SANCTUARY COVE DR
WEST PALM BEACH FL
33410-4517
US

IV. Provider business mailing address

1005 SANCTUARY COVE DR
WEST PALM BEACH FL
33410-4517
US

V. Phone/Fax

Practice location:
  • Phone: 787-955-6937
  • Fax:
Mailing address:
  • Phone: 787-955-6937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11024126
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: