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General NPI Number Information
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NPI Number | 1295192086
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Entity Type | Organization
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Legal Business Name | ANA M ACOSTA MD PA
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Dates
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Enumeration Date | 01/25/2016
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Last Update Date | 01/25/2016
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Provider Practice Location Address
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Address Line | 330 SW 27TH AVE STE 701
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City | MIAMI
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State | FL
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Zip | 33135-2968
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Country | US
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Telephone | 786-360-4423
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Fax | 786-360-6215
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Provider Business Mailing Address
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Address Line | 330 SW 27TH AVE STE 701
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City | MIAMI
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State | FL
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Zip | 33135-2968
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Country | US
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Telephone | 786-360-4423
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Fax | 786-360-6215
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Authorized Official
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Title or Position | MD/PRESIDENT
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Name | DR. ANA M ACOSTA
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Credential | MD
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Telephone | 786-360-4423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME 59402
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ACN 734
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License Number State | FL
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