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NPI Code Detail

MEDICARE: DR. YANET ACOSTA M.D

MEDICARE: DR. YANET ACOSTA 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
1207Q00000XFamily Medicine Physician036.135636IL
2207Q00000XFamily Medicine Physician137417FL

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 : 1184911067
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YANET ACOSTA M.D
Provider Business Mailing Address
First Line : 6101 PINE RIDGE RD
Second Line :
City : NAPLES
State : FL
Zip : 34119-3900
Country : US
Telephone Number : 239-348-4221
Fax Number :
Provider Business Practice Location Address
First Line : 4525 THOMASSON DR
Second Line :
City : NAPLES
State : FL
Zip : 34112-6962
Country : US
Telephone Number : 239-354-6500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2011
Last Update Date : 09/16/2020

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