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General NPI Number Information
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NPI Number | 1366480386
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Entity Type | Individual
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Provider Name | BRENDA M. ACOSTA ASHBY MD
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Gender | Female
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 03/28/2014
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Provider Practice Location Address
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Address Line | 3901 NW 79TH AVE STE 222
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City | DORAL
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State | FL
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Zip | 33166-6554
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Country | US
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Telephone | 786-845-8989
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Fax | 786-845-8615
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Provider Business Mailing Address
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Address Line | 3901 NW 79TH AVE STE 222
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City | DORAL
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State | FL
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Zip | 33166-6554
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Country | US
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Telephone | 786-845-8989
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Fax | 786-845-8615
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | ME95818
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License Number State | FL
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