Provider Demographics
NPI:1710097761
Name:ACOSTA, PAULO C (MD)
Entity Type:Individual
Prefix:MR
First Name:PAULO
Middle Name:C
Last Name:ACOSTA
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3443 DICKERSON PIKE
Mailing Address - Street 2:SUITE # 300
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-2519
Mailing Address - Country:US
Mailing Address - Phone:615-868-0200
Mailing Address - Fax:615-865-5999
Practice Address - Street 1:3443 DICKERSON PIKE
Practice Address - Street 2:SUITE # 300
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2519
Practice Address - Country:US
Practice Address - Phone:615-868-0200
Practice Address - Fax:615-865-5999
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2011-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNM.D.00000129432084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1114041548OtherGROUP NPI
TN3191642Medicaid
TNB04042Medicare UPIN
TN1114041548OtherGROUP NPI