Provider Demographics
NPI:1003336314
Name:ACOSTA, YAQUELIN MARIA
Entity Type:Individual
Prefix:
First Name:YAQUELIN
Middle Name:MARIA
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7810 TATUM WATERWAY DR APT 8
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-1863
Mailing Address - Country:US
Mailing Address - Phone:786-378-3349
Mailing Address - Fax:
Practice Address - Street 1:7810 TATUM WATERWAY DR
Practice Address - Street 2:APT 8
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141
Practice Address - Country:US
Practice Address - Phone:786-378-3349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician