Provider Demographics
NPI:1669475356
Name:ACOSTA, GILBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:GILBERTO
Middle Name:
Last Name:ACOSTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11350 MCCORMICK RD STE 501
Mailing Address - Street 2:
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031-1002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7964 SUMMERLIN LAKES DRIVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1816
Practice Address - Country:US
Practice Address - Phone:239-333-1177
Practice Address - Fax:239-333-1169
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 80978207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259911200Medicaid
H28892Medicare UPIN
FL259911200Medicaid
FL51598YMedicare PIN