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General NPI Number Information
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NPI Number | 1538038914
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Entity Type | Individual
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Provider Name | RAIKO NESTOR GRINAN ACOSTA APRN
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Gender | Male
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 1565 W 29TH ST
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City | HIALEAH
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State | FL
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Zip | 33012-5516
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Country | US
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Telephone | 305-537-4100
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Fax | 305-675-2860
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Provider Business Mailing Address
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Address Line | 9000 NW 15TH ST STE 6-7
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City | DORAL
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State | FL
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Zip | 33172-2988
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Country | US
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Telephone | 305-537-4766
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Fax | 305-675-2860
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11043348
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License Number State | FL
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