MEDICARE: SCOTT J. ACOSTA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	020534	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023018199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT J. ACOSTA MD

Provider Business Mailing Address
First Line	:	1101 MEDICAL CENTER BLVD
Second Line	:
City	:	MARRERO
State	:	LA
Zip	:	70072-3147
Country	:	US
Telephone Number	:	504-349-1297
Fax Number	:	504-349-1146

Provider Business Practice Location Address
First Line	:	1111 MEDICAL CENTER BLVD.
Second Line	:	STE. S850
City	:	MARRERO
State	:	LA
Zip	:	70072-3147
Country	:	US
Telephone Number	:	504-349-6450
Fax Number	:	504-349-6454

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	02/07/2014

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Directions to “ SCOTT J. ACOSTA MD” Practice Location

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