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General NPI Number Information
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NPI Number | 1891781332
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Entity Type | Organization
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Legal Business Name | GILBERTO J ACOSTA PODIATRIST INC
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 613 E 49TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-1963
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Country | US
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Telephone | 305-828-2288
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Fax | 305-828-2399
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Provider Business Mailing Address
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Address Line | 613 E 49TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-1963
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Country | US
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Telephone | 305-828-2288
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Fax | 305-828-2399
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GILBERTO J ACOSTA
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Credential | DPM
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Telephone | 305-828-2288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO 2800
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License Number State | FL
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