Provider Demographics
NPI:1104826882
Name:Y & G MEDICAL SERV
Entity Type:Organization
Organization Name:Y & G MEDICAL SERV
Other - Org Name:ACOSTA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-388-4711
Mailing Address - Street 1:1096 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-4634
Mailing Address - Country:US
Mailing Address - Phone:305-388-4711
Mailing Address - Fax:305-388-8122
Practice Address - Street 1:1096 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4634
Practice Address - Country:US
Practice Address - Phone:305-388-4711
Practice Address - Fax:305-388-8122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL343483-4332B00000X
FLPH18047333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy