Provider Demographics
NPI:1346432051
Name:ACOSTA, ROBERTO RAFAEL (MD)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:RAFAEL
Last Name:ACOSTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9960 NW 116TH WAY
Mailing Address - Street 2:SUITE 13
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1167
Mailing Address - Country:US
Mailing Address - Phone:786-924-1311
Mailing Address - Fax:786-924-1313
Practice Address - Street 1:12957 PALMS WEST DR
Practice Address - Street 2:SUITE 102
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-4932
Practice Address - Country:US
Practice Address - Phone:561-429-8189
Practice Address - Fax:561-331-8492
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2023-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME1052432084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology