Doctor Name: | PEDRO L ACOSTA |
NPI Number: | 1114278538 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | |
Business Practice Address: | 1001 N Federal Hwy Suite 355 Hallandale Beach, FL - 330092400 |
Business Phone Number: | 8004880279 |
Business Fax Number: | 8669028817 |
Mailing Address: | 1001 N Federal Hwy, Suite 355 HALLANDALE BEACH |
State: | FL |
Postal Code: | 330092400 |
Phone Number: | 8004880279 |
Fax Number: | 8669028817 |
NPI Enumeration Date: | 09/25/2012 |
NPI Last Update Date: | 10/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |