Provider Demographics
NPI:1174634117
Name:ACOSTA, WAIKA YAJAIRA (MD)
Entity Type:Individual
Prefix:DR
First Name:WAIKA
Middle Name:YAJAIRA
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1492
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-1492
Mailing Address - Country:US
Mailing Address - Phone:178-789-2495
Mailing Address - Fax:
Practice Address - Street 1:72 CALLE MALAGA
Practice Address - Street 2:URB. SALAMANCA
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4607
Practice Address - Country:US
Practice Address - Phone:787-892-4951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15036146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant