Provider Demographics
NPI:1669765236
Name:ACOSTA, NATALIA (BCBA)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:NATALIA
Other - Middle Name:
Other - Last Name:KRUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:19022 NE 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2823
Mailing Address - Country:US
Mailing Address - Phone:305-859-1731
Mailing Address - Fax:
Practice Address - Street 1:19022 NE 29TH AVE
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2823
Practice Address - Country:US
Practice Address - Phone:305-859-1731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-18-31175103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021087700Medicaid