Provider Demographics
NPI:1851003669
Name:ACOSTA, ANAMARIA C (PA-C)
Entity Type:Individual
Prefix:
First Name:ANAMARIA
Middle Name:C
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3000 MEDICAL PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4695
Mailing Address - Country:US
Mailing Address - Phone:813-879-8045
Mailing Address - Fax:813-978-3667
Practice Address - Street 1:3000 MEDICAL PARK DR STE 200
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4695
Practice Address - Country:US
Practice Address - Phone:813-879-8045
Practice Address - Fax:813-978-3667
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-23
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9116775363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical