Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | TP344 | KY |
N | 111NI0900X | Internist | TP344 | KY |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 89458 | GA |
NPI | 1609155969 |
---|---|
Provider Name | Dr. Giancarlo Acosta Baez |
First Address | Atlanta, GA 30374-2616 |
Second Address | Gainesville, GA 30501-3466 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2011 |
Last Update Date | 17/08/2021 |