MEDICARE: ALBERTO LOPEZACOSTA AP

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	225700000X	Massage Therapist	MA54547	FL
2	171100000X	Acupuncturist	AP3432	FL

General Provider Information

NPI Number	:	1447687504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALBERTO LOPEZACOSTA AP

Provider Business Mailing Address
First Line	:	2640 SW 28TH LN
Second Line	:
City	:	COCONUT GROVE
State	:	FL
Zip	:	33133-3135
Country	:	US
Telephone Number	:	305-608-4922
Fax Number	:

Provider Business Practice Location Address
First Line	:	2640 SW 28TH LN
Second Line	:
City	:	COCONUT GROVE
State	:	FL
Zip	:	33133-3135
Country	:	US
Telephone Number	:	305-608-4922
Fax Number	:

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

Provider Enumeration Date	:	10/03/2013
Last Update Date	:	03/27/2014

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Directions to “ ALBERTO LOPEZACOSTA AP” Practice Location

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