Provider Demographics
NPI:1598173395
Name:ACOSTA, IRIS MARIA (ARNP)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:MARIA
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 SW 72ND ST STE 502
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4830
Mailing Address - Country:US
Mailing Address - Phone:786-942-0706
Mailing Address - Fax:
Practice Address - Street 1:6200 SW 72ND ST STE 502
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4830
Practice Address - Country:US
Practice Address - Phone:786-942-0706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-25
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9180190363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care