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General NPI Number Information
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NPI Number | 1366190662
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Entity Type | Individual
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Provider Name | NICHOLAS ACOSTA DPT
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Gender | Male
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Dates
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Enumeration Date | 03/15/2022
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 1093 SHOTGUN RD
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City | SUNRISE
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State | FL
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Zip | 33326-1911
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Country | US
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Telephone | 786-405-4992
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Fax |
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Provider Business Mailing Address
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Address Line | 331 85TH ST APT 24
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City | MIAMI BEACH
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State | FL
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Zip | 33141-4803
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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 |
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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 | PT38344
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License Number State | FL
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