Provider Demographics
NPI:1275125379
Name:ACOSTA, VIOLETA MARIE (MS,CF-SLP)
Entity Type:Individual
Prefix:
First Name:VIOLETA
Middle Name:MARIE
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:MS,CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 SW 56TH ST STE 10
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7161
Mailing Address - Country:US
Mailing Address - Phone:786-542-5774
Mailing Address - Fax:305-470-7486
Practice Address - Street 1:10000 SW 56TH ST STE 10
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7161
Practice Address - Country:US
Practice Address - Phone:786-542-5774
Practice Address - Fax:305-470-7486
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ11074235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSZ11074OtherFLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE