Provider Demographics
NPI:1114278538
Name:ACOSTA, PEDRO L (PA-C)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:L
Last Name:ACOSTA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1001 N FEDERAL HWY
Mailing Address - Street 2:SUITE 355
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2400
Mailing Address - Country:US
Mailing Address - Phone:800-488-0279
Mailing Address - Fax:866-902-8817
Practice Address - Street 1:1001 N FEDERAL HWY
Practice Address - Street 2:SUITE 355
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2400
Practice Address - Country:US
Practice Address - Phone:800-488-0279
Practice Address - Fax:866-902-8817
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2012-10-03
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical