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General NPI Number Information
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NPI Number | 1033223003
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Entity Type | Organization
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Legal Business Name | NILDA ACOSTA MD PA
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 1235 N KROME AVE
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City | HOMESTEAD
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State | FL
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Zip | 33030-4204
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Country | US
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Telephone | 305-242-5336
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Fax | 305-242-5337
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Provider Business Mailing Address
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Address Line | 1235 N KROME AVE
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City | HOMESTEAD
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State | FL
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Zip | 33030-4204
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGED CARE SPECIALIST
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Name | NILDA ACOSTA
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Credential |
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Telephone | 800-654-0889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | ME61179
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License Number State | FL
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