Provider Demographics
NPI:1053846766
Name:ACOSTA, SHEYLA
Entity Type:Individual
Prefix:
First Name:SHEYLA
Middle Name:
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 1:1135 SW 12TH ST REAR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1826
Mailing Address - Country:US
Mailing Address - Phone:786-357-2485
Mailing Address - Fax:
Practice Address - Street 1:1135 SW 12TH ST REAR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-1826
Practice Address - Country:US
Practice Address - Phone:786-357-2485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other