Provider Demographics
NPI:1639382922
Name:ACOSTA, DIGNA
Entity type:Individual
Prefix:
First Name:DIGNA
Middle Name:
Last Name:ACOSTA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5529
Mailing Address - Country:US
Mailing Address - Phone:954-454-5777
Mailing Address - Fax:954-320-7521
Practice Address - Street 1:410 E HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-5529
Practice Address - Country:US
Practice Address - Phone:954-454-5777
Practice Address - Fax:954-320-7521
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS23838183500000X
FLME73994207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH02767Medicare UPIN