MEDICARE: MERCEDES MARIA 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	222Q00000X	Developmental Therapist

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	:	1326308230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERCEDES MARIA ACOSTA

Provider Business Mailing Address
First Line	:	6850 W 16TH DR APT 219
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-4459
Country	:	US
Telephone Number	:	786-278-0623
Fax Number	:	305-602-8466

Provider Business Practice Location Address
First Line	:	10550 NW 77TH CT
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33016
Country	:	US
Telephone Number	:	305-863-2233
Fax Number	:

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

Provider Enumeration Date	:	05/24/2012
Last Update Date	:	05/30/2018

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Directions to “ MERCEDES MARIA ACOSTA ” Practice Location

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