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General NPI Number Information
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NPI Number | 1285740803
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Entity Type | Individual
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Provider Name | JORGE ACOSTA
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Gender | Male
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 20601 E DIXIE HWY STE 300
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City | AVENTURA
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State | FL
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Zip | 33180-1540
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Country | US
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Telephone | 305-933-5942
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Fax |
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Provider Business Mailing Address
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Address Line | 15343 SW 178TH ST
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City | MIAMI
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State | FL
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Zip | 33187-7723
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Country | US
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Telephone | 305-278-0603
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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