Provider Demographics
NPI:1821406240
Name:ACOSTA, ANA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:M
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:M
Other - Last Name:ACOSTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:330 SW 27TH AVE
Mailing Address - Street 2:SUITE 701
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2968
Mailing Address - Country:US
Mailing Address - Phone:786-360-4423
Mailing Address - Fax:786-360-6215
Practice Address - Street 1:330 SW 27TH AVE
Practice Address - Street 2:SUITE 701
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2968
Practice Address - Country:US
Practice Address - Phone:786-360-4423
Practice Address - Fax:786-360-6215
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN734208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice