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General NPI Number Information
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NPI Number | 1083969323
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Entity Type | Individual
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Provider Name | LAZARO ACOSTA DDS
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Gender | Male
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Dates
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Enumeration Date | 07/23/2012
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Last Update Date | 07/23/2012
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Provider Practice Location Address
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Address Line | 15215 COLLIER BLVD SUITE 314
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City | NAPLES
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State | FL
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Zip | 34119-6834
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Country | US
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Telephone | 239-793-5599
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Fax |
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Provider Business Mailing Address
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Address Line | 7032 AMBROSIA LN APT 707
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City | NAPLES
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State | FL
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Zip | 34119-9652
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Country | US
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Telephone | 813-598-4301
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN19886
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN 19886
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License Number State | FL
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