Provider Demographics
NPI:1134908692
Name:ACOSTA SANZ, JANETTE FELISA (APRN)
Entity type:Individual
Prefix:
First Name:JANETTE
Middle Name:FELISA
Last Name:ACOSTA SANZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4745 DRESDEN CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-1206
Mailing Address - Country:US
Mailing Address - Phone:904-485-6600
Mailing Address - Fax:
Practice Address - Street 1:9471 BAYMEADOWS RD STE 107
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7968
Practice Address - Country:US
Practice Address - Phone:904-504-0504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11025805363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner