MEDICARE: ELVIRA B ACOSTA MD PC

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	207Q00000X	Family Medicine Physician	7576	NV

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	:	1942493465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELVIRA B ACOSTA MD PC

Provider Business Mailing Address
First Line	:	2001 S RAINBOW BLVD
Second Line	:	SUITE 160
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0824
Country	:	US
Telephone Number	:	702-233-2500
Fax Number	:	702-233-2525

Provider Business Practice Location Address
First Line	:	2001 S RAINBOW BLVD
Second Line	:	SUITE 160
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0824
Country	:	US
Telephone Number	:	702-233-2500
Fax Number	:	702-233-2525

Authorized Official
Title or Position	:	M.D.
Name	:	DR. ELVIRA B ACOSTA
Credential	:	M.D.
Telephone Number	:	702-233-2500

Provider Enumeration Date	:	08/20/2007
Last Update Date	:	07/26/2011

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