Provider Demographics
NPI:1356867915
Name:ACOSTA, ANAYANCI
Entity Type:Individual
Prefix:
First Name:ANAYANCI
Middle Name:
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35250 SW 177TH CT UNIT 23
Mailing Address - Street 2:
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034-5660
Mailing Address - Country:US
Mailing Address - Phone:305-764-0829
Mailing Address - Fax:
Practice Address - Street 1:35250 SW 177TH CT UNIT 23
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-5660
Practice Address - Country:US
Practice Address - Phone:305-764-0829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician