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NPI Code Detail

MEDICARE: DR. CARLOS ACOSTA OTEYZA M.D.

MEDICARE: DR. CARLOS ACOSTA OTEYZA M.D.
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
1208100000XPhysical Medicine & Rehabilitation PhysicianME43663FL

Other Identifiers

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

General Provider Information

NPI Number : 1063545341
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARLOS ACOSTA OTEYZA M.D.
Provider Business Mailing Address
First Line : 6144 GAZEBO PARK PL S STE 211
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32257-1086
Country : US
Telephone Number : 904-551-3122
Fax Number : 904-551-3481
Provider Business Practice Location Address
First Line : 6144 GAZEBO PARK PL S STE 211
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32257-1086
Country : US
Telephone Number : 904-551-3122
Fax Number : 904-551-3481
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 06/26/2014

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