Provider Demographics
NPI:1952456477
Name:ACOSTA, GILBERTO JOSE (DPM)
Entity Type:Individual
Prefix:
First Name:GILBERTO
Middle Name:JOSE
Last Name:ACOSTA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 E 49TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1963
Mailing Address - Country:US
Mailing Address - Phone:305-828-2288
Mailing Address - Fax:305-828-2399
Practice Address - Street 1:613 E 49TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1963
Practice Address - Country:US
Practice Address - Phone:305-828-2288
Practice Address - Fax:305-828-2399
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2800213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3484Medicare ID - Type UnspecifiedFL MEDICARE PROVIDER
FLE3484XMedicare PIN