MEDICARE: LILIANA BARBARA ACOSTA

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1124454178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILIANA BARBARA ACOSTA

Provider Business Mailing Address
First Line	:	11031 NE 6TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33161-7182
Country	:	US
Telephone Number	:	305-398-6100
Fax Number	:	305-398-6099

Provider Business Practice Location Address
First Line	:	790 E BROWARD BLVD
Second Line	:	400
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33301-2095
Country	:	US
Telephone Number	:	954-580-0770
Fax Number	:	954-580-0777

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

Provider Enumeration Date	:	09/23/2013
Last Update Date	:	09/23/2013

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