Provider Demographics
NPI:1760409775
Name:ACUNA, ADALBERTO BERNARDINO (OD)
Entity Type:Individual
Prefix:DR
First Name:ADALBERTO
Middle Name:BERNARDINO
Last Name:ACUNA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15600 NW 67TH AVE
Mailing Address - Street 2:210
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2174
Mailing Address - Country:US
Mailing Address - Phone:305-825-2020
Mailing Address - Fax:305-556-0557
Practice Address - Street 1:15600 NW 67TH AVE
Practice Address - Street 2:210
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2174
Practice Address - Country:US
Practice Address - Phone:305-825-2020
Practice Address - Fax:305-556-0557
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOP0002421152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL078740000Medicaid
FLU06557Medicare UPIN
FL078740000Medicaid