Provider Demographics
NPI:1073129334
Name:ACOSTA-MORENO, VALENTINA
Entity Type:Individual
Prefix:
First Name:VALENTINA
Middle Name:
Last Name:ACOSTA-MORENO
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 1:410 CELEBRATION PLACE
Mailing Address - Street 2:STE 208
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5434
Mailing Address - Country:US
Mailing Address - Phone:877-800-0239
Mailing Address - Fax:407-566-2499
Practice Address - Street 1:410 CELEBRATION PLACE
Practice Address - Street 2:STE 208
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5434
Practice Address - Country:US
Practice Address - Phone:877-800-0239
Practice Address - Fax:407-566-2499
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027445363A00000X
FLPA9117001363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical