MEDICARE: MAYRA 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	207RR0500X	Rheumatology Physician	107229	FL

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	:	1083861439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYRA ACOSTA MD

Provider Business Mailing Address
First Line	:	3661 S MIAMI AVE STE 801
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-4223
Country	:	US
Telephone Number	:	305-860-6260
Fax Number	:	305-860-6590

Provider Business Practice Location Address
First Line	:	3661 S MIAMI AVE STE 801
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-4223
Country	:	US
Telephone Number	:	305-860-6260
Fax Number	:	305-860-6590

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

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	08/02/2012

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Directions to “ MAYRA ACOSTA MD” Practice Location

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