Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN9312660 | FL |
N | 363LP2300X | Nurse Practitioner - Primary Care | ARNP9312660 | FL |
NPI | 1083089551 |
---|---|
Provider Name | Alida Acosta |
First Address | Miami, FL 33173-3570 |
Second Address | Miami, FL 33173-3570 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2015 |
Last Update Date | 29/10/2020 |