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NPI Code Detail

MEDICARE: SULAY LOY ACOSTA

MEDICARE: SULAY LOY 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
1183500000XPharmacistPS48507FL

General Provider Information

NPI Number : 1245511302
Entity Type Code : Individual
Provider Name (Legal Business Name) : SULAY LOY ACOSTA
Provider Business Mailing Address
First Line : 11836 MINFORD CIR S
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32246-1703
Country : US
Telephone Number : 904-383-6728
Fax Number :
Provider Business Practice Location Address
First Line : 1220 UNIVERSITY BLVD N
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-8852
Country : US
Telephone Number : 904-762-6892
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2011
Last Update Date : 10/28/2011

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Directions to “ SULAY LOY ACOSTA ” Practice Location

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