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General NPI Number Information
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NPI Number | 1184911067
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Entity Type | Individual
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Provider Name | YANET ACOSTA M.D
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Gender | Female
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 4525 THOMASSON DR
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City | NAPLES
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State | FL
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Zip | 34112-6962
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Country | US
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Telephone | 239-354-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 6101 PINE RIDGE RD
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City | NAPLES
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State | FL
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Zip | 34119-3900
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Country | US
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Telephone | 239-348-4221
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036.135636
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 137417
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License Number State | FL
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