Provider Demographics
NPI:1093478828
Name:ACOSTA, SHERMAINE CHLOE (APRN)
Entity Type:Individual
Prefix:
First Name:SHERMAINE
Middle Name:CHLOE
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SHERMAINE CHLOE
Other - Middle Name:TAJOR
Other - Last Name:NEPANGUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17000 PORTER RD
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-8915
Mailing Address - Country:US
Mailing Address - Phone:407-648-5384
Mailing Address - Fax:321-841-6975
Practice Address - Street 1:17000 PORTER RD
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-8915
Practice Address - Country:US
Practice Address - Phone:407-648-5384
Practice Address - Fax:321-841-6975
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11016076363LF0000X
FLAPRN11016076363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily